CMS Price Transparency Data

Neurobehavioral status check

Facility: Mc Donough District Hospital

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$109
about 0.5× the $221 Medicare rate · typically $82–$218
modeled estimate · not a bill or quote
What this hospital charges insurers
$87
Below the fair price — a good deal
about $22 under the fair price · 0.4× Medicare
Medicare pays $221 Fair price $109 This hospital $87

How we calculate the fair BaseRate →

How this hospital compares to other IL hospitals

A typical price — 5 charge more and 3 charge less, among the 9 IL hospitals compared.

Cheapest $73 Priciest $122

Black dot = this hospital, among the 9 IL hospitals with a price for this procedure. Full list below.

A fair price for a Neurobehavioral status check is about $109 (about 0.5× the $221 Medicare rate). Mc Donough District Hospital charges insurers about $87 — below the fair price — a good deal. Located in Macomb, IL.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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
UnitedHealthcaremajor $72 - $348 33%
Blue Cross Blue Shieldmajor $733 332%
Aetnamajor $76 - $733 34%
Humanamajor $76 - $733 34%
Meridian $76 - $348 34%
Molina $76 - $87 34%
+ 3 smaller / regional plans $46 - $348
Government programs also on file: Medicare, Medicaid, 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: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals