Neurobehavioral status check
Facility: Mercy Hospital Springfield
Billing Code: 96116 (CPT)
- CPT Billing Code: 96116
- Insurance Median: $171
- Cash Discount Price: $195
- vs. Medicare Baseline: 0.78x 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 |
|---|---|---|
| Blue Cross Blue Shield | $73 - $528 | 33% |
| Aetna | $83 - $150 | 38% |
| Humana | $83 - $204 | 38% |
| Medicaid / KanCare | $83 - $398 | 38% |
| Medica Contracted [320239] | $118 | 53% |
| Medica [20239] | $118 | 53% |
| Benefit Management Contracted [320052] | $120 | 54% |
| Health Systems Inc Contracted [320174] | $120 | 54% |
| Insurance System Inc Contracted [320465] | $120 | 54% |
| Ambetter / Centene | $122 | 55% |
| Home State Health Plan Contracted [320187] | $122 | 55% |
| Novasys Contracted [320285] | $122 | 55% |
| Administrative Payor Contracted [320005] | $135 - $150 | 61% |
| Evolutions Health Care Contracted [320124] | $135 | 61% |
| Point C Contracted [320238] | $135 - $225 | 61% |
| Point C [20238] | $135 | 61% |
| Medical Destinations Contracted [320242] | $150 | 68% |
| Mercy Benefit Admin Contracted [320251] | $150 - $180 | 68% |
| Workers Comp [20426] | $150 - $255 | 68% |
| United Medical Resources Contracted [320454] | $156 | 71% |
| First Health Contracted [320128] | $168 | 76% |
| Aither Health Contracted [320449] | $171 | 78% |
| Auxiant Contracted [320462] | $171 - $195 | 78% |
| Ebms Contracted [320493] | $171 | 78% |
| Edison Health Solutions Contracted [320502] | $171 | 78% |
| Healthlink Contracted [320179] | $171 - $240 | 78% |
| Imagine 360 Contracted [320494] | $171 | 78% |
| Reflect Health Contracted [320492] | $171 | 78% |
| Yuzu Health Contracted [320521] | $171 | 78% |
| 90 Degree Benefits Contracted [320436] | $180 | 82% |
| Federal Medical Center Contracted [320127] | $180 | 82% |
| Show-Me Health Administrators Contracted [320483] | $180 | 82% |
| Cigna | $207 - $231 | 94% |
| Multiplan Contracted [320270] | $231 | 105% |
| Private Health Care Systems Contracted [320320] | $231 | 105% |
| UnitedHealthcare | $231 - $451 | 105% |
| Compcare Of The Ozarks Contracted [320437] | $237 | 107% |
| American Healthcare Alliance Contracted [320020] | $240 | 109% |
| Qual Choice Contracted [320324] | $240 | 109% |
| Municipal Health Plan Contracted [320271] | $243 | 110% |
| Usa Managed Care Org Contracted [320429] | $264 | 120% |
| Ppo Plus Contracted [320310] | $270 | 122% |