CMS Price Transparency Data

Neurobehavioral status check

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $102
Cash Discount Price: $371
vs. Medicare Baseline: 0.46x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Univ. of Vermont - Fletcher Allen Health Care is $102. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $371. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.46x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$371

Average discount available for prompt cash payment at this facility.

Insurance Median

$102

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: $371 (168%)

Insurance Median: $102 (46%)

Cash: $371 (168% of Medicare)

Ins. Median: $102 (46% 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	$61 - $413	28%
Mvp	$64 - $337	29%
Blue Cross Blue Shield	$72 - $337	33%
Aetna	$75	34%
Humana	$75	34%
St. Regis	$75	34%
Veterans Affairs Community Care Network	$75	34%
Fidelis Care	$86	39%
Capital District Physicians' Health Plan	$87 - $173	39%
Martins Point	$87	39%
Cigna	$101 - $337	46%
Wellpath	$105 - $204	48%
Ebpa	$286	130%
Harvard Pilgrim	$297	135%
Magnacare	$297	135%
Coventry	$315	143%
Nppn	$334	151%

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 $371.
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 Univ. of Vermont - Fletcher Allen Health Care 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.