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Massachusetts rates for HCPCS 96116

Neurobehavioral status exam (clinical assessment of thinking, reasoning and judgment, [eg, acquired knowledge, attention, language, memory, planning and problem solving, and visual spatial abilities]), by physician or other qualified health care professional, both face-to-face time with the patient and time interpreting test results and preparing the report; first hour

Facilitymedian $105 · 10th–90th $81–$2340%20%10th90th$105Professionalmedian $98 · 10th–90th $72–$2140%10%10th90th$98$20.0$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $281.84
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $91.20 / $208.93
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
AllWays Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $588.84
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $120.23 / $537.03
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $138.04 / $223.87
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $97.72 / $181.97
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $120.23 / $134.90
Fallon Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $120.23 / $120.23
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $125.89 / $229.09
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$295.12 / $346.74 / $346.74
Health New England
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$512.86 / $512.86 / $512.86
Mass General Brigham
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $128.82 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$107.15 / $109.65 / $114.82
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $120.23 / $229.09