CMS Price Transparency Data

Neurobehavioral status check

Facility: Davis County Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $101
  • Cash Discount Price: $168
  • vs. Medicare Baseline: 0.46x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Davis County Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $168. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.46x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$168

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $168 (76%)
Insurance Median: $101 (46%)
Cash: $168 (76% of Medicare)
Ins. Median: $101 (46% 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
Aetna $84 38%
Choicecare Mcr Adv $91 41%
Home State Hlth Exch - All Other Plans $91 41%
Home State Hlth Mcr $91 41%
Mt Carmel Hp-All Plans $91 41%
Tricare $91 41%
Amerigroup Mcr Adv-All Other Plans $93 42%
American Hp Mcr Adv-All Plans $95 43%
Home State Hlth Mcaid $101 46%
Iowa Total Care Mcaid-All Plans $103 47%
Molina Mcaid-All Plans $104 47%
Amerigroup Mcaid $105 48%
Midlands Choice - All Plans $118 53%
Preferred Hlth Choices - All Plans $126 57%
Choicecare Comm - All Other Plans $160 73%
Blue Cross Blue Shield $717 - $790 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals