CMS Price Transparency Data
Neurobehavioral status check
Facility: Seattle Children's Hospital
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $167
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.76x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Seattle Children's Hospital is $167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.76x the Medicare baseline. Located in 4800 Sand Point Way Ne, Po Box C-5371, Seattle, WA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$167
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%)
Insurance Median: $167 (76%)
Ins. Median: $167 (76% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Child Hearing League [17301] | $45 | 20% |
| Hospice [17306] | $45 | 20% |
| Maple Lane School [17309] | $45 | 20% |
| Medicaid / KanCare | $45 | 20% |
| Chpw [15802] | $47 | 21% |
| Coordinated Care [15815] | $47 | 21% |
| Icw Wellpoint [15822] | $47 | 21% |
| Kaiser [15818] | $47 | 21% |
| Molina [15809] | $47 | 21% |
| Opticare [15895] | $47 | 21% |
| Wellpoint [15814] | $47 | 21% |
| Ubh Community & State [15819] | $50 | 23% |
| UnitedHealthcare | $50 - $208 | 23% |
| Eye Quest [15894] | $52 | 24% |
| Usfhp [12208] | $94 | 43% |
| Coordinated Care [12267] | $123 | 56% |
| Molina Marketplace [12831] | $128 | 58% |
| Cigna | $129 - $194 | 58% |
| Asuris [11900] | $130 | 59% |
| Asuris [11913] | $130 | 59% |
| Bridgespan Health Company [11906] | $130 | 59% |
| Pb Regence [11908] | $130 | 59% |
| Regence Ump [12263] | $130 | 59% |
| Regence [11903] | $130 | 59% |
| Regence [11909] | $130 | 59% |
| Chpw Cascade [12228] | $131 | 59% |
| Pb Premera [11601] | $154 | 70% |
| Premera [11600] | $154 | 70% |
| Administrators [13102] | $167 | 76% |
| Allied [13129] | $167 | 76% |
| Assurant Health Fc [13135] | $167 | 76% |
| Coastal Administrative [13140] | $167 | 76% |
| Ebms Fc [13144] | $167 | 76% |
| First Choice [13399] | $167 | 76% |
| Health Alliance [13233] | $167 | 76% |
| Ilwu-Pma [13158] | $167 | 76% |
| Loomis Benefits West [13161] | $167 | 76% |
| Meritain Health [13229] | $167 | 76% |
| Moda Fc [13219] | $167 | 76% |
| Myers Stevens & Toohey [13169] | $167 | 76% |
| Pacific Underwriters [13175] | $167 | 76% |
| Personify Fc [13155] | $167 | 76% |
| Providence Health Plan [13181] | $167 | 76% |
| Rehn & Associates [13182] | $167 | 76% |
| Samaritan Health [12265] | $167 | 76% |
| Starmark [13103] | $167 | 76% |
| Tongass Timber Trust [13202] | $167 | 76% |
| Trusteed Plans [13186] | $167 | 76% |
| Trustmark Life Insurance [13203] | $167 | 76% |
| Welfare Pension [13120] | $167 | 76% |
| Wship [13121] | $167 | 76% |
| Zenith American Solutions [13195] | $167 | 76% |
| Aetna | $187 | 85% |
| Ameriben [11006] | $187 | 85% |
| Christian Brothers [11001] | $187 | 85% |
| Coresource [11004] | $187 | 85% |
| Ebms [11003] | $187 | 85% |
| Kaiser [13400] | $187 | 85% |
| Kaiser [13401] | $187 | 85% |
| Meritain [12251] | $187 - $349 | 85% |
| Moda [11009] | $187 | 85% |
| Preferred One [11008] | $187 | 85% |
| Web Tpa [11007] | $187 | 85% |
| Allegiance [12264] | $194 | 88% |
| Personify [12270] | $194 | 88% |
| Providence Health Plan [12289] | $194 | 88% |
| Tufts Health Plan [12279] | $194 | 88% |
| Claritev [12299] | $349 | 158% |
| Ebms [12241] | $349 | 158% |
| Health Alliance [12266] | $349 | 158% |
| Humana | $349 | 158% |
| Key Benefit Admin [12276] | $349 | 158% |
| Medical Mutual [12233] | $349 | 158% |
| Moda [12842] | $349 | 158% |
| Nippon Life Insurance [12232] | $349 | 158% |
| Pehp [12235] | $349 | 158% |
| Preferredone Admin Services [12236] | $349 | 158% |
| Select Health [12277] | $349 | 158% |