CMS Price Transparency Data

Neurobehavioral status check

Facility: Mercy Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $302
  • Cash Discount Price: $1,260
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Mercy Medical Center is $302. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,260. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.37x the Medicare baseline. Located in 1320 Mercy Drive Nw, Canton, OH.
Cash / Self-Pay
$1,260

Average discount available for prompt cash payment at this facility.

Insurance Median
$302

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: $1,260 (571%)
Insurance Median: $302 (137%)
Cash: $1,260 (571% of Medicare)
Ins. Median: $302 (137% 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
Summacare $49 - $643 22%
United $55 - $1,186 25%
Caresource $56 - $151 25%
Buckeye $57 - $151 26%
Amerihealth $60 - $161 27%
Molina $60 - $154 27%
Aetna $75 - $1,938 34%
Blue Cross Blue Shield $75 - $1,243 34%
Cigna $75 - $1,010 34%
Humana $75 - $288 34%
The Health Plan $75 - $1,938 34%
Mmo $77 - $594 35%
Communicare $79 - $302 36%
Perennial Health $81 - $311 37%
Zing Health $83 - $316 38%
Aultcare $86 - $795 39%
Oscar $179 - $745 81%
Ohcp $261 - $942 118%
Omas $335 - $969 152%
Phphi $402 - $1,163 182%
Gms $469 - $1,357 213%
Immergrun $502 - $969 228%
Multiplan $603 - $1,744 273%
Cc Ehp $773 - $785 350%
Amish Community Aid Plan $872 - $969 395%
Ohio Healthy $1,047 475%
Php $1,163 527%
Medical Benefit Corp $1,357 615%
Consociate Health $1,454 659%
Frontpath $1,744 791%
Managed Care Services $1,744 791%
Tertiary Care Network $1,744 791%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 Mercy Drive Nw, Canton, OH 44708
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals