Exam of neurobehavioral status, each additional hour
Medicare pricing data for 1,368 providers across 50 states
Note: These costs reflect the Medicare physician/supplier component. Hospital facility fees are billed separately and can be 2-5x the physician fee.
💡 What You Should Know
Exam of neurobehavioral status, each additional hour (HCPCS code 96121) is a medical procedure billed to Medicare. The average Medicare-allowed cost is $72.66, but hospitals typically charge $222.83 — a 3.1x markup. Prices vary significantly by state and provider.
🏷️ Typical Out-of-Pocket Cost
Medicare patients typically pay about 20% of the allowed amount as coinsurance. Based on the average allowed cost of $72.66, your out-of-pocket cost would be approximately $14.53. Actual costs depend on your specific plan, deductible, and whether you've met your annual out-of-pocket maximum.
What Hospitals Charge vs. What Medicare Pays
Hospitals charge 3.1x more than what Medicare allows for this procedure. Medicare actually pays $56.66 on average.
Cost by State
Medicare-allowed amounts vary significantly by state
| State | Allowed Cost | Hospital Charge | Providers | Services | vs. National |
|---|---|---|---|---|---|
| Alaska | $104 | $381 | 4 | 145 | +43.7% |
| New Jersey | $78 | $246 | 25 | 506 | +7.7% |
| New York | $78 | $251 | 78 | 1,070 | +6.9% |
| Hawaii | $76 | $188 | 5 | 56 | +5.0% |
| Washington | $75 | $222 | 17 | 133 | +3.9% |
| Rhode Island | $75 | $191 | 4 | 23 | +3.8% |
| Delaware | $75 | $250 | 1 | 62 | +3.5% |
| Colorado | $75 | $181 | 29 | 739 | +3.4% |
| Puerto Rico | $75 | $81 | 4 | 35 | +2.9% |
| Illinois | $75 | $239 | 51 | 1,251 | +2.7% |
| District of Columbia | $74 | $236 | 11 | 204 | +2.4% |
| Maryland | $74 | $237 | 48 | 512 | +2.3% |
| Vermont | $74 | $243 | 6 | 30 | +1.9% |
| Montana | $74 | $185 | 10 | 131 | +1.6% |
| Florida | $74 | $212 | 113 | 3,130 | +1.5% |
| Oregon | $74 | $155 | 21 | 653 | +1.3% |
| Arizona | $74 | $174 | 36 | 2,008 | +1.2% |
| Texas | $73 | $208 | 113 | 4,231 | +1.1% |
| Wyoming | $73 | $279 | 2 | 99 | +0.6% |
| West Virginia | $73 | $289 | 5 | 42 | +0.1% |
| Indiana | $73 | $172 | 7 | 211 | -0.1% |
| Oklahoma | $73 | $210 | 3 | 35 | -0.1% |
| Connecticut | $72 | $238 | 21 | 188 | -0.6% |
| South Carolina | $72 | $226 | 11 | 500 | -0.6% |
| Georgia | $72 | $202 | 16 | 248 | -0.7% |
| California | $72 | $264 | 186 | 5,948 | -0.8% |
| New Mexico | $72 | $195 | 12 | 265 | -1.0% |
| North Carolina | $72 | $250 | 35 | 969 | -1.2% |
| Michigan | $72 | $190 | 66 | 1,342 | -1.2% |
| Iowa | $72 | $219 | 17 | 354 | -1.5% |
| Minnesota | $71 | $283 | 31 | 182 | -1.7% |
| Pennsylvania | $71 | $206 | 60 | 540 | -2.5% |
| Massachusetts | $71 | $198 | 47 | 1,253 | -2.6% |
| Tennessee | $71 | $202 | 15 | 560 | -2.7% |
| Ohio | $69 | $184 | 53 | 383 | -5.1% |
| Maine | $69 | $268 | 17 | 211 | -5.3% |
| Alabama | $69 | $222 | 14 | 67 | -5.4% |
| Arkansas | $69 | $177 | 8 | 33 | -5.6% |
| Louisiana | $68 | $187 | 10 | 44 | -6.8% |
| Nebraska | $68 | $303 | 8 | 96 | -6.9% |
| Missouri | $67 | $259 | 5 | 14 | -7.2% |
| Kentucky | $67 | $224 | 14 | 177 | -7.3% |
| Mississippi | $67 | $232 | 6 | 169 | -7.8% |
| Virginia | $66 | $185 | 36 | 916 | -8.5% |
| Wisconsin | $66 | $333 | 44 | 606 | -8.5% |
| Nevada | $66 | $178 | 2 | 94 | -9.0% |
| North Dakota | $66 | $149 | 6 | 44 | -9.1% |
| New Hampshire | $66 | $140 | 3 | 83 | -9.5% |
| South Dakota | $65 | $68 | 3 | 23 | -10.2% |
| Idaho | $64 | $157 | 4 | 96 | -11.9% |
⚠️ Important: These costs reflect the Medicare physician/supplier component. Hospital facility fees may be billed separately. Total out-of-pocket costs may be higher.
💊 Need post-procedure medications? Check costs on OpenPrescriber