CMS Price Transparency Data

Neurobehavioral status check

Facility: Mercy Hospital Kingfisher, Inc

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $221
  • Cash Discount Price: $276
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Mercy Hospital Kingfisher, Inc is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $276. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.00x the Medicare baseline. Located in 1000 Hospital Drive, Kingfisher, OK.
Cash / Self-Pay
$276

Average discount available for prompt cash payment at this facility.

Insurance Median
$221

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: $276 (125%)
Insurance Median: $221 (100%)
Cash: $276 (125% of Medicare)
Ins. Median: $221 (100% 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
Aetna $83 - $291 38%
Humana $83 - $179 38%
Medicaid / KanCare $83 - $128 38%
Ambetter / Centene $128 58%
Home State Health Plan Contracted [320187] $128 58%
Novasys Contracted [320285] $128 58%
Webtpa Contracted [320417] $178 81%
Blue Cross Blue Shield $179 - $225 81%
Cherokee Nation Health Serv Contracted [320066] $179 81%
Cross Timbers Hospice [20098] $179 81%
Dept Of Veteran Affairs Contracted [320106] $179 81%
Elara Caring Aspire Hospice Contracted [320433] $179 81%
Elara Caring Aspire Hospice [20433] $179 81%
Halo Hcr Inc Hospice Contracted [320432] $179 81%
Halo Hcr Inc Hospice [20432] $179 81%
Independent Health [20197] $179 81%
Indian Health Service Contracted [320198] $179 81%
Kindful Hospice Contracted [320434] $179 81%
Kindful Hospice [20434] $179 81%
Medical Associates Health [20444] $179 81%
Medicare (plans) $179 - $302 81%
Mercy Hospice Okc [20252] $179 81%
Provider Partners Health Plans Contracted [320450] $179 81%
Qual Choice Contracted [320325] $179 81%
Tricare $179 81%
UnitedHealthcare $179 - $297 81%
Globalhealth Contracted [320145] $183 83%
Cigna $185 - $289 84%
Aither Health Contracted [320449] $255 - $361 116%
Mercy Benefit Admin Contracted [320251] $255 - $361 116%
Quik Trip Contracted [320447] $255 116%
Show-Me Health Administrators Contracted [320483] $255 116%
Benefit Management Contracted [320052] $276 - $319 125%
United Medical Resources Contracted [320454] $297 135%
Osma Health Contracted [320292] $298 135%
Medica Contracted [320239] $302 137%
Healthcare Highways Plus Contracted [320175] $319 145%
First Health Contracted [320128] $332 150%
Auxiant Contracted [320462] $361 164%
Ebms Contracted [320493] $361 164%
Healthlink Contracted [320179] $361 164%
Imagine 360 Contracted [320494] $361 164%
Reflect Health Contracted [320492] $361 164%
Yuzu Health Contracted [320521] $361 164%
Health Choice Contracted [320166] $623 282%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Hospital Drive, Kingfisher, OK 73750
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals