CMS Price Transparency Data

Neurobehavioral status check

Facility: Munson Healthcare Cadillac Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $150
  • Cash Discount Price: $204
  • vs. Medicare Baseline: 0.68x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Munson Healthcare Cadillac Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.68x the Medicare baseline. Located in 400 Hobart St, Cadillac, MI.
Cash / Self-Pay
$204

Average discount available for prompt cash payment at this facility.

Insurance Median
$150

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: $204 (92%)
Insurance Median: $150 (68%)
Cash: $204 (92% of Medicare)
Ins. Median: $150 (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
Mclaren Health Plan $50 - $215 23%
Meridian $50 - $113 23%
Molina $50 - $232 23%
Priority Health $50 - $449 23%
UnitedHealthcare $50 - $215 23%
Blue Cross Blue Shield $51 - $126 23%
American Health Associates $72 - $215 33%
Autumnwood Of Mcbain Skilled Nursing $72 - $215 33%
Blue Care Network $72 - $215 33%
Hap (Health Alliance Plan) $72 - $215 33%
Humana $72 - $215 33%
Medicare (plans) $72 - $215 33%
Michigan Amish Medical Board $72 - $215 33%
Promedica $72 - $215 33%
Samaritas Senior Living Skilled Nursing $72 - $215 33%
Wellcare (Meridian) $72 - $215 33%
Provider Network Of America Group Health $100 - $204 45%
Aetna $105 - $215 48%
Cofinity $105 - $187 48%
Asr/Physicians Care $108 - $192 49%
Cigna $108 - $449 49%
Employee Benefits Logistics $122 - $366 55%
Hospice Of Michigan $144 65%
Munson Hospice $168 - $852 76%
Enterprise Group Planning/Employee Benefit Plan $192 87%
Medical Cost Savings Solution $192 87%
Nomi Health $192 87%
Robbing Group And Regency Employee Benefits $192 87%
First Health/Coventry Network $204 92%
Three Rivers Provider Network $204 92%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Hobart St, Cadillac, MI 49601
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals