CMS Price Transparency Data

Neurobehavioral status check

Facility: Shirley Ryan Abilitylab

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $411
  • Cash Discount Price: $390
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Shirley Ryan Abilitylab is $411. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.86x the Medicare baseline. Located in 355 E Erie St, Chicago, IL.
Cash / Self-Pay
$390

Average discount available for prompt cash payment at this facility.

Insurance Median
$411

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: $390 (177%)
Insurance Median: $411 (186%)
Cash: $390 (177% of Medicare)
Ins. Median: $411 (186% 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
Health Care Services Corporation $96 - $312 44%
Aetna $96 - $1,225 44%
Paradigm Health Corporation $170 - $422 77%
Humana $228 103%
Tricare $228 103%
UnitedHealthcare $228 - $374 103%
Wellcare Meridian Fide $228 103%
Advocate Health Partners $231 - $650 105%
Blue Cross Blue Shield $302 - $1,225 137%
Uic Physician Group-Campuscare $325 - $358 147%
Hfn $329 - $585 149%
Multiplan $339 154%
Coventry Workers Comp $339 154%
Corvel Corporation $339 154%
State of Illinois $346 157%
Personalcare Insurance of Il/Firsthealth Grp Corp/Coventryhealth and Life Insurance Co $346 - $552 157%
Uic Physician Group $358 - $526 162%
Endeavor Health Sites 243/447 Northshore and Edwards $358 162%
Union Health Service $364 165%
Cigna $366 - $399 166%
University of Chicago Practice Plan $390 - $422 177%
Affordable Health Care Concepts $391 177%
Loyola University Physician Foundation $422 191%
Health Care Services Corporation DBA Managed Care Network Preferred $443 - $578 201%
Advocate and Advocate Health Partners $455 206%
Gallagher Benefit Administrators $488 221%
Resurrection Health Care Preferred $488 - $520 221%
Unicare Life and Health Insurance $507 230%
Health Care Services Corporation D/B/A HMO Illinois $507 230%
Private Healthcare Systems $520 236%
Health Payors Organization $552 250%
Cofinity Aka Ppom $552 250%
Healthnetwork $572 - $618 259%
Meridian Health Plan $650 295%
County Care $1,225 555%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 E Erie St, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL