CMS Price Transparency Data

Neurobehavioral status check

Facility: Mercy Medical Center

Billing Code: 96116 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$161

about 0.7× the $221 Medicare rate · typically $112–$325

modeled estimate · not a bill or quote

What this hospital charges insurers

$137

Below the fair price — a good deal

about $24 under the fair price · 0.6× Medicare

Medicare pays $221 Fair price $161 This hospital $137 Cash price $1,260 Hospital's list price $1,938

How we calculate the fair BaseRate →

How this hospital compares to other OH hospitals

A typical price — 4 charge more and 4 charge less, among the 9 OH hospitals compared.

Cheapest $90 Priciest $193

Black dot = this hospital, among the 9 OH hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Neurobehavioral status check is about $161 (about 0.7× the $221 Medicare rate). Mercy Medical Center charges insurers about $137, or about $1,260 in cash — below the fair price — a good deal. Located in Canton, OH.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$55 - $1,186	25%
Blue Cross Blue Shieldmajor	$75 - $1,243	34%
Aetnamajor	$75 - $1,938	34%
Cignamajor	$75 - $1,010	34%
Humanamajor	$75 - $288	34%
AmeriHealth	$60 - $161	27%
CareSource	$56 - $151	25%
Molina	$60 - $154	27%
Oscar Health	$179 - $745	81%
UniCare	$79 - $302	36%
+ 18 smaller / regional plans	$49 - $1,938

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 1,260), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 96116.

Insurance Before you use insurance

Call your insurance company to confirm Mercy Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 96116.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Mercy Medical Center

Compare: Neurobehavioral status check at other OH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.