CMS Price Transparency Data

Neurobehavioral status check

Facility: Beloit Health System

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $281
Cash Discount Price: $185
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Beloit Health System is $281. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.27x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$281

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: $185 (84%)

Insurance Median: $281 (127%)

Cash: $185 (84% of Medicare)

Ins. Median: $281 (127% 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
Aetna	$73 - $608	33%
Blue Cross Blue Shield	$73	33%
Dean Health	$73	33%
Independent Care Health Plan	$73	33%
Quartz	$73 - $365	33%
UnitedHealthcare	$73 - $112	33%
Naphcare	$110	50%
Cook Children'S Health Plan (Cchp)	$112	51%
The Alliance	$183	83%
Wps	$293	133%
Humana	$296	134%
Wea Trust	$352	160%
Multiplan	$512	232%
Health Eos	$582	264%
Cigna	$608	276%
Hfn	$608	276%
Preferred Network Access	$608	276%

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 $185.
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 Beloit Health System 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.