CMS Price Transparency Data

Neurobehavioral status check

Facility: Decatur County Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $151
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Decatur County Hospital is $151. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.68x the Medicare baseline. Located in 1405 Nw Church Street, Leon, IA.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$151

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: $142 (64%)
Insurance Median: $151 (68%)
Cash: $142 (64% of Medicare)
Ins. Median: $151 (68% 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
Blue Cross Blue Shield $57 26%
Champva -All Plans $80 36%
Everystep Hospice-All Plans $93 42%
Aetna $96 - $141 44%
Tricare $96 44%
UnitedHealthcare $107 - $151 49%
Benefit Admin System-All Plans $116 53%
Humana $130 59%
Meritain Health-All Plans $130 59%
Misc Commercial-All Plans $130 59%
All Savers-All Plans $134 61%
Allied Benefit System-All Plans $134 61%
American Family Ins Grp-All Plans $134 61%
Rural Carrier Benefit Plan-All Plans $137 62%
Christian Healthcare -All Plans $142 64%
Medica-All Other Plans $142 64%
Golden Rule-All Plans $151 68%
Ntca The Rural Broadband-All Plans $151 68%
Cigna $153 69%
Medical Mutual-All Plans $157 71%
Farm Bureau Financial-All Other Plans $160 73%
Farm Bureau Property And Ca $160 73%
Medi Share-All Plans $162 73%
Uhss-All Plans $162 73%
Health Partners-All Plans $164 74%
Lewermark-All Plans $169 77%
Mail Handlers Benefit-All Plans $174 79%
Midlands Choice-All Plans $174 79%
Priority Health-All Plans $178 81%
Iowa Total Care Mcaid-All Plans $182 83%
Amerigroup Mcaid-All Plans $187 85%
Wellmark Hmo $1,370 621%
Wellmark Ppo - All Other Plans $1,507 683%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1405 Nw Church Street, Leon, IA 50144
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals