CMS Price Transparency Data

Neurobehavioral status check

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $334
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.51x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Essentia Health St Joseph's Medical Center is $334. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.51x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$334

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%)
Insurance Median: $334 (151%)
Ins. Median: $334 (151% 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
Primewest $303 137%
Itasca Med Care $311 141%
Advocare/Security Health $334 151%
Blue Cross Blue Shield $334 - $1,160 151%
Freedom Blue Ppo $334 151%
Healthpartners Care Msho / Mcr Adv $334 151%
Imcare Msho Pcc Prime $334 151%
Imcare Msho Ref Req $334 151%
Medica Advantage Solutions $334 151%
Medica Msho/Dual Solutions $334 151%
Medica Prime Solution Group $334 151%
Medicare (plans) $334 151%
Nd Va Administration $334 151%
Platinum Blue/Vantage Blue $334 151%
Primewest Msho $334 151%
Secure Blue Msho $334 151%
Ubh Cost Plan $334 151%
Ubh Msho $334 151%
Ucare Msho $334 151%
UnitedHealthcare $334 151%
Blue Plus Pmap Pcc Prime $1,061 481%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals