CMS Price Transparency Data

Neurobehavioral status check

Facility: Pullman Regional Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $199
  • Cash Discount Price: $205
  • vs. Medicare Baseline: 0.90x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Pullman Regional Hospital is $199. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.90x the Medicare baseline. Located in 835 S Bishop Blvd, Pullman, WA.
Cash / Self-Pay
$205

Average discount available for prompt cash payment at this facility.

Insurance Median
$199

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: $205 (93%)
Insurance Median: $199 (90%)
Cash: $205 (93% of Medicare)
Ins. Median: $199 (90% 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.

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
Community Care Ntwrk Mcare-All Plans $84 38%
Humana $84 38%
Kaiser Mcare Advan $84 38%
Sterling Mcr Adv-All Plans $84 38%
Triwest - All Plans $84 38%
Blue Cross Blue Shield $85 - $229 39%
Community Health Plan Mcaid-All Plans $87 39%
Medicaid / KanCare $87 39%
Molina Hlthcare Mcaid-All Plans $87 39%
Wellcare Mcaid -All Other Plans $87 39%
Wellpoint Mcaid - All Plans $87 39%
Wellcare Mcr Adv $92 42%
Idaho Dshs-All Plans $99 45%
Premera First - All Plans $176 80%
Single Case Agree - All Plans $176 80%
First Choice Admin $199 90%
Admin Wsu Student-All Plans $205 93%
Multiplan - All Plans $205 93%
Asuris Nw Hlth-All Plans $217 98%
Cigna $217 98%
First Choice - All Other Plans $217 98%
Focus Hlthcare - All Plans $217 98%
Northwest One - All Plans $217 98%
UnitedHealthcare $217 98%
Aetna $229 104%
Great West Hlth-All Plans $229 104%
Integrated Hp - All Plans $229 104%
Spokane Phco - All Plans $229 104%
Provider Network Of America-All Plans $236 107%
Kaiser - All Other Plans $475 215%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 835 S Bishop Blvd, Pullman, WA 99163
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals