CMS Price Transparency Data

Neurobehavioral status check

Facility: Multicare Covington Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $679
  • Cash Discount Price: $544
  • vs. Medicare Baseline: 3.08x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Multicare Covington Medical Center is $679. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $544. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 3.08x the Medicare baseline. Located in 17700 Se 272Nd St, Covington, WA.
Cash / Self-Pay
$544

Average discount available for prompt cash payment at this facility.

Insurance Median
$679

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: $544 (247%)
Insurance Median: $679 (308%)
Cash: $544 (247% of Medicare)
Ins. Median: $679 (308% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 308% of the Medicare baseline (a markup of 208%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $350 - $1,453 159%
Regence $350 159%
UnitedHealthcare $353 - $1,607 160%
Molina $357 - $628 162%
Wellcare $357 162%
Community Health Plan Of Washington $374 - $573 170%
Coordinated Care $434 197%
Wellpoint $434 197%
Pacificsource $476 - $686 216%
Premera $525 - $1,441 238%
Ambetter / Centene $679 308%
First Choice $885 - $1,610 401%
First Health $992 450%
Multiplan/Phcs $992 450%
Cigna $1,169 530%
Kaiser $1,171 531%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 17700 Se 272Nd St, Covington, WA 98042
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals