CMS Price Transparency Data

Neurobehavioral status check

Facility: Ochsner Stennis Memorial Hospital

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 96116
Insurance Median: $240
Cash Discount Price: $257
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Neurobehavioral status check at Ochsner Stennis Memorial Hospital is $240. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.09x the Medicare baseline. Located in 14365 Highway 16 West, De Kalb, MS.

Cash / Self-Pay

$257

Average discount available for prompt cash payment at this facility.

Insurance Median

$240

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: $257 (117%)

Insurance Median: $240 (109%)

Cash: $257 (117% of Medicare)

Ins. Median: $240 (109% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Humana	$61 - $342	28%
Cigna	$74 - $342	34%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$74 - $345	34%
Medicaid / KanCare	$74	34%
Medicare (plans)	$74 - $393	34%
UnitedHealthcare	$74 - $295	34%
Shared Health Mississippi	$77 - $359	35%
Prime Health Services Ppo	$85 - $455	39%
Ambetter / Centene	$103 - $345	47%
Primewell Health Services Commercial Exchange Plan	$118 - $381	53%
Primewell Health Services – Commercial	$118 - $381	53%
Select Administrative Services Network	$122 - $521	55%
Blue Cross Blue Shield	$126 - $495	57%
Aetna	$150 - $370	68%
Prime Health Services Ppo -Workers Comp	$151 - $340	68%
Cor Vel	$153 - $348	69%
Zelis	$205 - $427	93%
Claritev D/B/A Multiplan/Phcs/American Life Care	$248 - $427	112%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $257.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 96116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Stennis Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 96116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.