CMS Price Transparency Data
Neurobehavioral status check
Facility: Clovis Community Medical Center
Billing Code: 96116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 96116
- Insurance Median: $97
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.44x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Clovis Community Medical Center is $97. 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 0.44x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
Unavailable
Average discount available for prompt cash payment at this facility.
Insurance Median
$97
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: $97 (44%)
Ins. Median: $97 (44% 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 |
|---|---|---|
| Medi-Cal California Health & Wellness Plan | $84 | 38% |
| Medi-Cal Health Plan of San Mateo | $84 | 38% |
| Medi-Cal Kern Family Health | $84 | 38% |
| Generic Care Out of County | $84 | 38% |
| San Francisco Health Plan Medi-Cal | $84 | 38% |
| Medi-Cal Community Health Group | $84 | 38% |
| Medi-Cal La Care Health | $84 | 38% |
| Cal Caloptima | $84 | 38% |
| Genetically Handicapped Person | $84 | 38% |
| Ccs Kern | $84 | 38% |
| Ccs Madera/Sacramento | $84 | 38% |
| Santa Clara Family Health Plan - Valley Health | $84 | 38% |
| Ccs Tulare | $84 | 38% |
| Ccs Merced | $84 | 38% |
| Medi-Cal Alameda Alliance for Health | $84 | 38% |
| Generic Ccs Other Counties | $84 | 38% |
| Ccs Kings | $84 | 38% |
| Medi-Cal Partnership Health Plan of Ca | $84 | 38% |
| Gold Coast Medi-Cal | $84 | 38% |
| Medi-Cal Inland Empire Health | $84 | 38% |
| Chdp | $84 | 38% |
| Medi-Cal Cencal Health | $84 | 38% |
| Medi-Cal Molina | $84 | 38% |
| Medi-Cal Blue Shield Promise Health | $84 | 38% |
| Ccs Fresno | $84 | 38% |
| Santa Clara Family Health Plan - Premier Health | $84 | 38% |
| Ccs Mariposa | $84 | 38% |
| Medi-Cal Contra Costa Health Plan | $84 | 38% |
| Blue Cross Blue Shield | $84 - $278 | 38% |
| Ccs Stanislaus | $84 | 38% |
| Blue Shield | $84 - $278 | 38% |
| Fresno County Funded Specialty Care | $84 | 38% |
| Bscphp HMO - First Choice | $97 - $278 | 44% |
| Blue Shield Hmo-Cvmp/Medpro | $97 - $278 | 44% |
| Healthnet Sante | $97 - $278 | 44% |
| Sante-Sub Cap Ma Brand New Day | $97 - $278 | 44% |
| Wellcare | $97 - $278 | 44% |
| Care1St HMO - Ehs | $97 - $278 | 44% |
| Healthnet Sante - Sub Cap Dual Risk | $97 - $278 | 44% |
| Medi-Cal Innovative Integrated Health | $97 - $278 | 44% |
| Blue Shield 65 Plus HMO First Choice | $97 - $278 | 44% |
| Cigna | $97 - $278 | 44% |
| Medicare (plans) | $97 - $278 | 44% |
| Bscphp - First Choice | $97 - $278 | 44% |
| Us Marshal | $97 - $278 | 44% |
| Generic Victims of Crime | $97 - $278 | 44% |
| Sante-Blue Shield/Sante | $97 - $278 | 44% |
| Hartford Life Supplement | $97 - $278 | 44% |
| Healthnet HMO - Cvmp/Medpro | $97 - $278 | 44% |
| Blue Shield Saint Agnes | $97 - $278 | 44% |
| Sante-Healthnet Seniority | $97 - $278 | 44% |
| Meritage Blue Shield 65 Plus | $97 - $278 | 44% |
| Healthnet HMO - Sante | $97 - $278 | 44% |
| Blue Shield Promise - Imperial | $97 - $278 | 44% |
| Sante Sub Cap-Blue Shield/Sante | $97 - $278 | 44% |
| Railroad Part A | $97 - $278 | 44% |
| Gemcare HMO | $97 - $278 | 44% |
| Blue Shield Sante | $97 - $278 | 44% |
| Sante Sub Cap Healthnet Seniority | $97 - $278 | 44% |
| Humana | $97 - $278 | 44% |
| Generic | $97 - $278 | 44% |
| Scan Health Plan | $97 - $278 | 44% |
| Generic Bscphp | $97 - $278 | 44% |
| Todays Pyramid | $97 - $278 | 44% |
| Blue Shield 65 Plus HMO Ehs | $97 - $278 | 44% |
| Railroad Part B | $97 - $278 | 44% |
| UnitedHealthcare | $97 - $282 | 44% |
| Well Path (Cfmg) | $97 | 44% |
| Healthnet HMO - Dhmso | $97 - $278 | 44% |
| Cares Act Provider Relief Fund | $97 - $278 | 44% |
| Advantek Table Mountain Rancheria Tribal Member | $97 - $278 | 44% |
| Sante | $97 - $278 | 44% |
| Victims of Crime | $97 - $278 | 44% |
| Healthnet Sante Dual Risk | $97 - $278 | 44% |
| Bscphp - Dhmso | $97 - $278 | 44% |
| Meritage Healthnet HMO | $97 - $278 | 44% |
| Healthnet HMO - La Salle | $97 - $278 | 44% |
| Aetna | $97 - $388 | 44% |
| Meritage Brand New Day | $97 - $278 | 44% |
| Sequoia Pace - Peak Tpa | $97 - $278 | 44% |
| Railroad Part A & B | $97 - $278 | 44% |
| Brand New Day | $97 - $278 | 44% |
| Innovative Integrated Health Community Plans HMO | $107 - $305 | 49% |
| Champion Health Plan of California Ma | $107 - $305 | 49% |
| Alignment Health Plan | $107 - $305 | 49% |
| Imperial Health Plan HMO | $112 - $319 | 51% |
| Sequoia Pace | $125 | 57% |
| Health Plan of San Joaquin | $125 | 57% |
| Correctcare Integrated Health | $126 - $361 | 57% |
| Adventist -McL Calviva Sub Cap | $138 | 63% |
| Healthnet | $161 | 73% |
| Coalinga State Hospital | $194 - $555 | 88% |
| Naphcare Inc-Mendota | $209 - $597 | 95% |
| Kaiser | $221 | 100% |