CMS Price Transparency Data

Neurobehavioral status check

Facility: Swedish Issaquah

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$510

about 2.3× the $221 Medicare rate · typically $317–$677

modeled estimate · not a bill or quote

What this hospital charges insurers

$458

Below the fair price — a good deal

about $52 under the fair price · 2.1× Medicare

Medicare pays $221 Fair price $510 This hospital $458

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

Highest price of the 9 WA hospitals we have prices for — worth calling around.

Cheapest $73 Priciest $458

Black dot = this hospital, among the 9 WA hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $510 (about 2.3× the $221 Medicare rate). Swedish Issaquah charges insurers about $458 — below the fair price — a good deal. Located in Issaquah, WA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

6 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana✓ Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$263 - $1,064	119%
Blue Cross Blue Shieldmajor	$271 - $839	123%
Aetnamajor	$258 - $261	117%
Cignamajor	$301	136%
Humanamajor	$266	121%
Kaiser Permanentemajor	$251 - $376	114%
Amerigroup	$276	125%
Providence Health Plan	$557	252%
+ 3 smaller / regional plans	$401 - $1,266

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Swedish Issaquah is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Swedish Issaquah

Compare: Neurobehavioral status check at other WA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.