CMS Price Transparency Data

Neurobehavioral status check

Facility: Mercyone Des Moines Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $202
  • Cash Discount Price: $202
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Mercyone Des Moines Medical Center is $202. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $202. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.92x the Medicare baseline. Located in 1111 6Th Ave, Des Moines, IA.
Cash / Self-Pay
$202

Average discount available for prompt cash payment at this facility.

Insurance Median
$202

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: $202 (92%)
Insurance Median: $202 (92%)
Cash: $202 (92% of Medicare)
Ins. Median: $202 (92% 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 Choices $63 29%
Medical Associates $63 29%
1199 National Benefit Fund $108 49%
Aetna $108 49%
Allied Benefit Systems $108 49%
Asr Health Benefits $108 49%
Christian Brother Services $108 49%
Coventry $108 49%
First Health $108 49%
Lucent Health $108 49%
Luminare Health $108 49%
Medical Mutual $108 49%
Meritain $108 49%
Trustmark Small Business Benefits $108 49%
Webtpa $108 49%
Cigna $187 85%
Health Partners $197 89%
Auxiant $202 92%
Medica $202 92%
Midlands $202 92%
Midlands Choice $202 92%
Blue Benefit Administrators Of Massachusetts $221 100%
Blue Care Network $221 100%
Blue Cross Blue Shield $221 100%
Blue Distinction Transplant $221 100%
Blue Shield - Ca $221 100%
Blue Shield - Id (Regence) $221 100%
Blue Shield - Ny Highmark Northeastern $221 100%
Blue Shield - Ny Highmark Western $221 100%
Blue Shield - Pa (Highmark) $221 100%
Blue Shield - Wa (Regence) $221 100%
UnitedHealthcare $258 - $352 117%
Usa Managed Care $264 120%
Crime Victim Assistance $311 141%
Iowa Dept Of Public Health $311 141%
Geha $320 145%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1111 6Th Ave, Des Moines, IA 50314
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals