CMS Price Transparency Data

Neurobehavioral status check

Facility: Central Vermont Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $110
Cash Discount Price: $570
vs. Medicare Baseline: 0.50x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Central Vermont Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $570. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.50x the Medicare baseline. Located in Box 547, Barre, VT.

Cash / Self-Pay

$570

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $570 (258%)

Insurance Median: $110 (50%)

Cash: $570 (258% of Medicare)

Ins. Median: $110 (50% 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
Humana	$74	34%
Aetna	$75	34%
Cigna	$75 - $220	34%
Coventry	$75	34%
Veterans Affairs Community Care Network	$75	34%
Blue Cross Blue Shield	$77 - $116	35%
Mvp	$77 - $249	35%
Martins Point	$87	39%
UnitedHealthcare	$87 - $212	39%
Capital District Physicians' Health Plan	$141	64%
Wellpath	$313	142%
Harvard Pilgrim	$456	207%

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 $570.
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 Central Vermont Medical Center 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.