CMS Price Transparency Data

Neurobehavioral status check

Facility: Dickenson Community Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $257
Cash Discount Price: $126
vs. Medicare Baseline: 1.17x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Dickenson Community Hospital is $257. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.17x the Medicare baseline. Located in 312 Hospital Drive, Clintwood, VA.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$257

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$220.6

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $220.6 (100%)

Cash / Self-Pay: $126 (57%)

Insurance Median: $257 (117%)

Cash: $126 (57% of Medicare)

Ins. Median: $257 (117% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $220.6 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
UnitedHealthcare	$83 - $548	38%
Blue Cross Blue Shield	$102 - $856	46%
Aetna	$164 - $1,161	74%
Amerigroup	$164 - $257	74%
Managed Medicaire	$164 - $257	74%
Medicare (plans)	$164 - $257	74%
Sentara Health	$164 - $316	74%
United Mine Workers Of America	$164 - $257	74%
Humana	$167 - $261	76%
Molina Healthcare	$171 - $1,161	78%
Cigna	$173 - $397	78%
Devoted Health Plan	$173 - $270	78%
Nhc Advantage	$173 - $270	78%
Medcost	$192	87%
Ambetter / Centene	$203 - $317	92%
Seven Corners, Inc.	$548 - $856	248%
Optima Health	$1,116	506%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $126.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Dickenson Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.