CMS Price Transparency Data

Neurobehavioral status check

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $192
Cash Discount Price: $190
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at University of Iowa Health Care Medical Center Down is $192. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.87x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$192

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: $190 (86%)

Insurance Median: $192 (87%)

Cash: $190 (86% of Medicare)

Ins. Median: $192 (87% 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
Immergrun	$28 - $96	13%
UnitedHealthcare	$42 - $556	19%
Iowa Total Care	$45 - $305	20%
Molina Healthcare	$45 - $154	20%
Blue Cross Blue Shield	$54 - $296	24%
Healthpartners	$56 - $356	25%
Medical Associates	$56 - $376	25%
Quad City Community Healthcare	$56 - $288	25%
Midlands Choice	$59 - $368	27%
Aetna	$67 - $293	30%
Oscar Health	$71 - $242	32%
Great River Health Systems	$78 - $269	35%
Wellpoint (Amerigroup)	$78 - $308	35%
Aplos Health Plan	$90 - $307	41%
Sedgwick	$90 - $307	41%
Global Excel	$95 - $326	43%
Sanford Health Plan	$95 - $326	43%
Sisco	$99 - $338	45%
Employee Benefit Systems	$101 - $346	46%
Healthsmart	$101 - $346	46%
Hfn	$103 - $353	47%
Multiplan	$103 - $353	47%

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 $190.
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 University of Iowa Health Care Medical Center Down 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.