Neurobehavioral status check
Facility: Centura St. Catherine-Dodge City
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $74
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.34x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Kaiser | $74 | 34% |
| Humana | $74 | 34% |
| Kansas Health | $74 | 34% |
| Blue Cross Blue Shield | $74 | 34% |
| Cigna | $74 | 34% |
| Aetna | $74 | 34% |
| Medicare (plans) | $74 | 34% |
Consumer Guidance & Cost Commentary
For the CPT code 96116, representing a neurobehavioral status check at Centura St. Catherine-Dodge City in Dodge City, Kansas, the negotiated rates across seven payers, including Kaiser, Humana, and Medicare, are consistently set at $74.00. This rate aligns exactly with the state-wide average for this service. While commercial insurance contracts often result in higher administrative costs that can inflate prices to 200% to 300% of the Medicare benchmark, this facility's negotiated rate remains at the median level. Medicare itself benchmarks this procedure at $220.60, indicating that the commercial negotiated rate of $74.00 is significantly lower than the federal baseline, which typically serves as the objective cost measure for healthcare delivery.
Patients should be aware that cash-pay options or prompt-pay discounts may offer further savings, particularly if an individual's insurance deductible has not yet been met, as they would be responsible for the full negotiated rate of $74.00. Since the facility is a proprietary acute care hospital, it is advisable to contact the billing department directly to inquire about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount for upfront payment. Additionally, because over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before finalizing payment to ensure no unbundled codes or services not rendered are included in the final charge.