CMS Price Transparency Data

Neurobehavioral status check

Facility: Davis County Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$245
about 1.1× the $221 Medicare rate · typically $101–$497
modeled estimate · not a bill or quote
Medicare pays $221 Fair price $245 Cash price $168 Hospital's list price $168

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ Blue Cross Blue Shield✓ Aetna UnitedHealthcareCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
Blue Cross Blue Shieldmajor $717 - $790 325%
Aetnamajor $84 38%
Amerigroup $93 - $105 42%
Molina $104 47%
+ 9 smaller / regional plans $91 - $160
Government programs also on file: Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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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