CMS Price Transparency Data

Neurobehavioral status check

Facility: Mercy Health Saint Mary's

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $135
  • Cash Discount Price: $210
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Mercy Health Saint Mary's is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $210. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.61x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$210

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $210 (95%)
Insurance Median: $135 (61%)
Cash: $210 (95% of Medicare)
Ins. Median: $135 (61% 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

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicaid / KanCare $58 - $232 26%
Aetna $60 - $203 27%
Albany County Correctional Facility $60 27%
Ambetter / Centene $60 27%
Amish Mennonite $60 27%
Ascension St. Vincent Public Safety Medical $60 27%
Bccp $60 27%
Blue Cross Blue Shield $60 - $156 27%
Bmc Healthnet $60 27%
Breast Grant-Connecticut $60 27%
Broward County Dept Of Health $60 27%
California Health And Wellness $60 27%
Cardinal Innovations Lme $60 27%
Care Connections Of Northern Iowa $60 27%
Care Oregon Ohp $60 27%
Cencal Health Plan $60 27%
Cenpatico $60 27%
Chhuny $60 27%
Childrens Comm Health Plan $60 27%
Childrens Medical Services Title 19 $60 27%
Cigna $60 - $236 27%
City Of Philadelphia $60 27%
Cmh Allegan County $60 - $323 27%
Cmh Ausable Valley $60 - $323 27%
Cmh Barry County $60 - $323 27%
Cmh Bay-Arenac County $60 27%
Cmh Berrien County $60 - $323 27%
Cmh Cass County $60 - $323 27%
Cmh Central Mi County $60 27%
Cmh Clinton-Eaton-Ingham County $60 - $323 27%
Cmh Detroit Wayne Integrated Health Network $60 27%
Cmh Genesee County $60 27%
Cmh Ionia County $60 27%
Cmh Jackson County/Lifeways $60 27%
Cmh Kalamazoo $60 - $323 27%
Cmh Kent County $60 - $323 27%
Cmh Lenawee County $60 - $323 27%
Cmh Livingston County $60 27%
Cmh Macomb $60 27%
Cmh Misc $60 - $323 27%
Cmh Monroe County $60 - $323 27%
Cmh Montcalm County $60 - $323 27%
Cmh Muskegon County $60 - $323 27%
Cmh Newaygo County $60 - $323 27%
Cmh North Country $60 - $323 27%
Cmh Northern Lakes County $60 - $323 27%
Cmh Oakland County $60 27%
Cmh Ottawa County $60 - $323 27%
Cmh Van Buren County $60 - $323 27%
Cmh Washtenaw County $60 27%
Cmh Wayne County/Carelink $60 27%
Cmh Wayne Cty/Com Liv Svcs $60 27%
Cmh West Mi County $60 - $323 27%
Community Benefit Health $60 27%
Community Care Behavorial Health $60 27%
Community Care Partners $60 27%
Community Health Choice $60 27%
Connections Csp $60 27%
County Coroner $60 27%
County Funding Generic $60 27%
Covid19 Hrsa Uninsured Testing And Treatment Fund $60 27%
Dean Wi Badgercare $60 27%
Delaware County Department Of Health $60 27%
Delaware First Health $60 27%
Delta Dental Nj $60 27%
Dph Tb Program $60 27%
Dscc $60 27%
Eastpointe Lme $60 27%
Family Health Network $60 27%
Freedom First Healthcare $60 27%
Fresno County Ccs $60 27%
Ghc Scw Wi Badgercare $60 27%
Harbor Health $60 27%
Health Safety Net $60 27%
Healthy Blue Ne $60 27%
Hennepin Health $60 27%
Humana $60 - $323 27%
Id County Ada $60 27%
Id County Canyon $60 27%
Id County Cat Fund $60 27%
Id County Other $60 27%
Id County Payette $60 27%
Idaho Dept Health And Wellfare $60 27%
Idaho Womens Health Check $60 27%
Indiana Breast Cervical Cancer $60 27%
Inland Empire Health Plan $60 27%
Intercommunity Health Ohp $60 27%
Iowa Total Care $60 27%
Jai Medical System $60 27%
Kern Family Health Plan $60 27%
Keystone First $60 27%
Keystone First Chip $60 27%
La Care Health Plan $60 27%
Lakeland Care Inc $60 27%
Managed Health Services - Indiana $60 27%
Maryland Breast & Cervical Program $60 27%
Maryland Healthy Smiles - Scion Dental $60 27%
Maryland Physicians Care $60 27%
Massachusetts Behavioral Health Partnership $60 27%
Mdwise $60 27%
Medi-Cal $60 27%
Medi-Cal Healthnet $60 27%
Medstar Dc Healthy Family $60 27%
Medstar Md Health Choice $60 27%
Mo Home State Health Plan $60 27%
Molina Centennial Care $60 27%
Nascentia Health Options $60 27%
Nebraska Total Care $60 27%
New York Cancer Services Program $60 27%
Nextlevel Health $60 27%
Oregon Screenwise $60 27%
Pace Of Southwest Michigan $60 - $90 27%
Paramount Advantage $60 27%
Parkland Community Health Plan $60 27%
Partners Behavioral Lme $60 27%
Peach State Healthplan $60 27%
Philadelphia County Funding $60 27%
Presbyterian Centennial Care $60 27%
Prestige Health Choice $60 27%
Priority Partners $60 27%
Robert F Sing Program $60 27%
Rx 340B Pass Along $60 27%
Rx Assistance/Rx Manufacturer Assistance 0 Copay $60 27%
Rx Medi-Cal $60 27%
Rx Meridian Rx $60 27%
Ryan White Florida Mssrp $60 27%
Sandhills Center Lme $60 27%
Screening For Life $60 27%
St Joseph County Hlth Dpt $60 27%
Stephenson Cty Health $60 27%
Sunshine State Health Plan $60 27%
Superior Health $60 27%
Tenncare $60 27%
Texas Children'S Health Plan $60 27%
Trillium Community Ohp $60 27%
Tufts Health Public Plans $60 27%
UnitedHealthcare $60 - $323 27%
Vaya Health Lme $60 27%
Washtenaw Health Plan $60 27%
Wellsense Health Plan $60 27%
Wi Womens Wellness $60 27%
Cca - Zing Health $84 38%
Champva $85 39%
Tricare $85 39%
Triwest Health Alliance $85 39%
Us Family Health Plan $85 39%
Veterans Eval Services $85 39%
Ally Align Care Adv $90 41%
American Health Advantage Of Idaho $90 41%
American Health Plan $90 41%
Aurora Special Needs $90 41%
Blue Care Network Advantage $90 41%
Blue Shield - De (Highmark) Medciare Advantage $90 41%
Care Dimensions $90 41%
Care Improvement Plus $90 41%
Care Resources Pace $90 41%
Careplus Health Plans $90 41%
Cca Senior Care Options $90 41%
Central Valley Medical Services Corp Pace $90 41%
Champion Health Plan Mcr Advantage $90 41%
Clear Spring Health $90 41%
Clover Health $90 41%
Commonwealth Care Alliance $90 41%
Community Pace At Home $90 41%
Eddy Senior Care-Pace $90 41%
Eddy Seniorcare Pace $90 41%
Elementcare $90 41%
Evercare $90 41%
Everence $90 41%
Gateway Health Plan $90 41%
Genesys Pace Of Genesee County $90 41%
Georgia Health Advantage $90 41%
Gold Advantage $90 41%
Gpa Croell Redi Mix $90 41%
Health America Advantra $90 41%
Highmark Health Options Dual Plan $90 41%
Hope Select Pace $90 41%
Horizon Nj Total Care $90 41%
Hudson Headwaters Pace $90 41%
Huron Valley Pace $90 41%
Innovative Integrated Health Community Plans $90 41%
Iowa Health Advantage $90 41%
Johns Hopkins Advantage Md $90 41%
Lasso Healthcare Msa $90 41%
Life St Marys Pace $90 41%
Lifecircles Pace $90 41%
Longevity Health Plan $90 41%
Martins Point Generations Advantage $90 41%
Mass General Brigham Mcr Adv $90 41%
Medicare (plans) $90 - $94 41%
Medipak Advantage $90 41%
Mercy Life $90 41%
Mercyone Cedar Valley $90 41%
Meridian Complete $90 41%
Michigan Complete Health $90 41%
Nascentia Health Plus $90 41%
New Centry Health Careplus $90 41%
Osu Prime Care Advantage $90 41%
Pace Cny $90 41%
Pace Iowa Immanuel Pathways $90 41%
Pace Southeast $90 41%
Pace-Trinity Health $90 41%
Peak Pace Solutions $90 41%
Perennial Advantage $90 41%
Preferred Care Partners $90 41%
Presbyterian Senior Plan $90 41%
Provider Partners Health Plan Of Illinois $90 41%
Provider Partners Health Plan Of Indiana $90 41%
Pruitthealth Premier $90 41%
Reliance Community Care Partners Care Resources Pace $90 41%
Rx Allwin $90 41%
Rx Grane Grnmedd $90 41%
Rx Retiree Rx Care $90 41%
Scan Health Plan Mcr Ipa Meritage Oon $90 41%
Secure Horizons Ma Pffs $90 41%
Serenity Pace $90 41%
Siouxland Pace $90 41%
Solis Health Plans $90 41%
Sunnyview-Pace Finance Dept $90 41%
Texan Plus $90 41%
The Health Plan $90 - $186 41%
Thome Pace $90 41%
Todays Options $90 41%
Tribute Health Plans $90 41%
Um Health Advantage $90 41%
Union Health Service $90 41%
Welbe Health $90 41%
Wellmed $90 41%
Align Senior Care $92 42%
Veterans Administration $92 42%
Hap $93 - $250 42%
Health Partners $93 42%
Tufts Health Plan $93 42%
Access Health $103 47%
Longevity Ipa Of Michigan Llc Health Plan Isnp $103 47%
Geha $112 - $245 51%
Asr Health Benefits $120 - $205 54%
1199 National Benefit Fund $124 - $236 56%
Allied National Global Care $124 - $236 56%
Asrm - Reliance Standard Life Insurance $124 - $236 56%
Blue Benefit Administrators Of Massachusetts $124 - $156 56%
Blue Distinction Transplant $124 - $156 56%
Blue Shield - Ca $124 - $156 56%
Blue Shield - Id (Regence) $124 - $156 56%
Blue Shield - Ny Highmark Northeastern $124 - $156 56%
Blue Shield - Ny Highmark Western $124 - $156 56%
Blue Shield - Pa (Highmark) $124 - $156 56%
Blue Shield - Wa (Regence) $124 - $156 56%
Christian Care Ministry $124 - $236 56%
Dean Health $124 - $236 56%
Fallon Health $124 - $236 56%
Family Life Insurance Company $124 - $236 56%
International Benefit Administrators $124 - $236 56%
Lifetime Benefit Solutions $124 - $236 56%
Manhattan Life $124 - $236 56%
Molina Marketplace $124 56%
Multiplan $124 - $236 56%
Mvp $124 - $236 56%
Oscar $124 56%
Pai $124 - $236 56%
Pan-American Life $124 - $236 56%
Phcs $124 - $236 56%
Trinity Health Share $124 - $236 56%
Wellpath $124 56%
American Postal Workers Secondary $126 57%
Wc Accident Fund $128 - $176 58%
Wc Advantage $128 - $176 58%
Wc Aig $128 - $176 58%
Wc Allied $128 - $176 58%
Wc Amerisure $128 - $176 58%
Wc Amtrust $128 - $176 58%
Wc Asu Risk Mgt $128 - $176 58%
Wc Berkley Admin $128 - $176 58%
Wc Broadspire $128 - $176 58%
Wc Bunch & Associates $128 - $176 58%
Wc Ccmsi $128 - $176 58%
Wc Emc Insurance Company $128 - $176 58%
Wc Esis $128 - $176 58%
Wc Fcci $128 - $176 58%
Wc Federated $128 - $176 58%
Wc Gallagher Bassett $128 - $176 58%
Wc Genex Care For Ohio $128 - $176 58%
Wc Guard Insurance Company $128 - $176 58%
Wc Hartford $128 - $176 58%
Wc Liberty Mutual $128 - $176 58%
Wc Meijers $128 - $176 58%
Wc Michigan $128 - $176 58%
Wc Mitchell Frankenmuth $128 - $176 58%
Wc Pma $128 - $176 58%
Wc Sedgwick $128 - $176 58%
Wc Sentry $128 - $176 58%
Wc Travelers $128 - $176 58%
Wc Tristar $128 - $176 58%
Wc Walmart $128 - $176 58%
Wc Zurich $128 - $176 58%
Partners Direct Health - Brio $133 60%
Priority Health $134 - $638 61%
Acclaim $135 - $246 61%
Administrative Concepts $135 - $246 61%
Allegeant $135 - $246 61%
Allied Benefit Systems $135 - $186 61%
Ameriben $135 - $246 61%
American Family $135 - $246 61%
American Healthcare Alliance $135 - $246 61%
American National $135 61%
American Republic $135 - $246 61%
Amerihealth $135 - $246 61%
Andrie Inc $135 61%
Aultcare $135 - $246 61%
Automated Benefit Services $135 - $246 61%
Auxiant $135 - $246 61%
Benefit Administrative Systems,Llc $135 - $246 61%
Boon Chapman $135 - $246 61%
Cam Administrative Services $135 - $246 61%
Christian Brother Services $135 - $246 61%
Christian Brothers Holy Cross $135 - $246 61%
Claimchoice Adminstrators $135 - $186 61%
Comprehensive Benefits $135 - $246 61%
Consociate $135 - $186 61%
Continental Life Insurance $135 - $246 61%
Coventry $135 - $256 61%
Custom Benefit Administrators $135 - $246 61%
Cypress Benefit Administrators $135 - $186 61%
East Greenbush Central School District $135 61%
Employee Benefit Concepts $135 - $246 61%
Employee Benefit Management $135 - $246 61%
Enterprise Group Planning $135 - $246 61%
First Health $135 - $256 61%
Forest County Potawatomi $135 - $186 61%
Freedom Life Insurance Company $135 - $246 61%
Genex Wc $135 61%
Group Administrators $135 - $246 61%
Group Marketing Services $135 - $246 61%
Group Pension Administrators $135 - $236 61%
Guardian $135 - $246 61%
Health America $135 - $246 61%
Health Choices $135 - $246 61%
Health Smart $135 - $186 61%
Healthcare Management Admin $135 61%
Healthez $135 - $246 61%
Healthgram $135 - $186 61%
Healthscope $135 - $186 61%
Healthsmart Workers Comp $135 61%
Insight $135 - $246 61%
Jag Source $135 61%
Jfp Benefit Management $135 - $246 61%
Jp Farley Corporation $135 - $246 61%
Key Benefit Administrator $135 - $246 61%
Liberty Union Life Assurance Co $135 - $246 61%
Lucent Health $135 - $246 61%
Luminare Health $135 - $246 61%
Luminare Health (Detroit) $135 - $246 61%
Magnacare $135 61%
Medben $135 - $246 61%
Medcost $135 - $246 61%
Medical Mutual $135 - $203 61%
Mutual Health Services $135 - $246 61%
Mutual Of Omaha $135 - $246 61%
Ncas $135 - $246 61%
New York State Insurance Fund $135 61%
Nippon Life Ins $135 - $246 61%
Njm Insurance Group $135 61%
Nova $135 - $246 61%
Painters Union Insurance Fund $135 - $246 61%
Physicians Mutual $135 - $246 61%
Plumbers Local 98 Insurance Fund $135 - $246 61%
Prairie States $135 - $246 61%
Preferred One $135 - $203 61%
Primary Physician Care $135 - $246 61%
Professional Benefit Administrators $135 - $246 61%
Rx Heatlhcomp $135 61%
Rx Restat $135 61%
Rx Saif Opdp Wc $135 61%
Rx Worker'S Comp $135 61%
Secureone Preferred United Plans $135 - $186 61%
Siho Insurance Services $135 61%
Sisco Benefits $135 - $186 61%
The Loomis Company $135 - $246 61%
Trustmark Small Business Benefits $135 - $186 61%
Unicare $135 - $246 61%
Unified Group Services $135 - $186 61%
Valenz $135 - $246 61%
Wc Ace $135 61%
Wc Acs Federal Employees $135 61%
Wc Acuity $135 61%
Wc Aegis $135 61%
Wc Aims $135 61%
Wc Alaska National Ins $135 61%
Wc Align Network $135 61%
Wc Am Trust N America $135 61%
Wc American Claims Mgmt $135 61%
Wc Benetech $135 61%
Wc Broward County $135 61%
Wc California State Comp Ins $135 61%
Wc California State Ins Fund $135 61%
Wc Capitol Area Health Consortium $135 61%
Wc Chartis $135 61%
Wc Chubb $135 61%
Wc Cirma $135 61%
Wc City Of Albany $135 61%
Wc City Of Sioux City $135 61%
Wc Claims Mgmt Inc $135 61%
Wc Cna $135 61%
Wc Comp One Admin C/O Manageability $135 61%
Wc Compone Admin $135 61%
Wc Corvel $135 61%
Wc Ct Healthcare Trust $135 61%
Wc Donegal Insurance Group $135 61%
Wc Employee Mutual $135 61%
Wc Enablecomp $135 61%
Wc Encore Health Network $135 61%
Wc Erie $135 61%
Wc Evolutions $135 61%
Wc Fed Ex $135 61%
Wc Federal Black Lung $135 61%
Wc Finley Occupational Health $135 61%
Wc First Agency/Occunet $135 61%
Wc Ford Motor $135 61%
Wc Fresno Unified Emp $135 61%
Wc General Motors $135 61%
Wc Generic $135 61%
Wc Great West Casualty $135 61%
Wc Guarantee Insurance $135 61%
Wc Hab $135 61%
Wc Hastings $135 61%
Wc Health Management $135 61%
Wc Heritage Summit $135 61%
Wc Hireright $135 61%
Wc Horizon $135 61%
Wc Icw Group $135 61%
Wc Idaho State Ins Fund $135 61%
Wc Intercare Insurance $135 61%
Wc Intermountain $135 61%
Wc Johns Eastern $135 61%
Wc Kemberton $135 61%
Wc Key Ins & Benefit Solutions $135 61%
Wc Mac Risk Management $135 61%
Wc Massachusetts $135 61%
Wc Mdia $135 61%
Wc Meadowbrook Claim $135 61%
Wc Medical Administrators $135 61%
Wc Memic $135 61%
Wc Mercy Workcare $135 61%
Wc Michigan Millers Mutual $135 61%
Wc Mra $135 61%
Wc Nationwide $135 61%
Wc Nca Comp $135 61%
Wc New York $135 61%
Wc New York Special Funds $135 61%
Wc North American Rishces $135 61%
Wc Northeast Health $135 61%
Wc Notre Dame $135 61%
Wc Novanet $135 61%
Wc O'Hara Corp $135 61%
Wc Occ Health Allen $135 61%
Wc Ohio Bureau $135 61%
Wc One Call Medical $135 61%
Wc Paradigm $135 61%
Wc Peerless $135 61%
Wc Praxis Health Network $135 61%
Wc Price Chopper $135 61%
Wc Procura Management $135 61%
Wc Qualcare $135 61%
Wc Quiktrip $135 61%
Wc Reny Company $135 61%
Wc Rev Claims $135 61%
Wc Risico $135 61%
Wc Rural Mutual $135 61%
Wc Saif Oregon $135 61%
Wc Secura $135 61%
Wc Sheakley Unicomp $135 61%
Wc Smile Lodge $135 61%
Wc Society $135 61%
Wc Srs $135 61%
Wc Taconic (Mro) $135 61%
Wc Taconic Farms $135 61%
Wc Triad Group $135 61%
Wc Troy Ny $135 61%
Wc Tyson $135 61%
Wc Unified Health Services $135 61%
Wc United Heartland $135 61%
Wc Us Dept Of Labor $135 61%
Wc Velocity $135 61%
Wc West Bend $135 61%
Wc West Bend Mutual/Argent $135 61%
Wc Winnebago Industries $135 61%
Wc Yankee Trails $135 61%
Wc York Risk $135 61%
Wc Zenith $135 61%
Webtpa $135 - $186 61%
Western & Southern Financial Group $135 - $246 61%
Wps $135 - $246 61%
Us Health And Life $137 - $246 62%
Blue Care Network $141 - $156 64%
Claimdoc $142 64%
Kent County Jail $142 64%
Muskegon County Jail $142 64%
Nomi Health $142 - $181 64%
Bcn Domestic $156 71%
Kaiser Domestic $156 71%
Meritain $157 - $203 71%
Varipro $168 - $210 76%
U Of M Health Plan $184 - $246 83%
Acs Benefit Services $186 84%
Caresource $211 96%
Bcccp-Michigan $232 105%
Intercare $232 - $246 105%
Ghc Scw $236 107%
Medi Share $236 107%
Paramount Hmo $236 107%
Magellan Behavioral Health $323 146%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Jefferson Avenue Se, Grand Rapids, MI 49503
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals