CMS Price Transparency Data

Neurobehavioral status check

Facility: St David's Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $291
  • Cash Discount Price: $786
  • vs. Medicare Baseline: 1.32x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at St David's Medical Center is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $786. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 1.32x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$786

Average discount available for prompt cash payment at this facility.

Insurance Median
$291

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: $786 (356%)
Insurance Median: $291 (132%)
Cash: $786 (356% of Medicare)
Ins. Median: $291 (132% 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
Superior Health Plan $39 - $134 18%
Amerigroup $83 38%
Blue Cross Blue Shield $117 - $251 53%
Oscar $151 - $168 68%
Moda $185 84%
United $196 - $354 89%
Covenant Management Systems $226 102%
Healthcare Highways $229 - $236 104%
Imo Med - Select Network $236 107%
Cigna $252 - $322 114%
Nomi Health $252 - $291 114%
Aetna $277 - $434 126%
Moda Health $283 - $291 128%
Evry Health $289 131%
Texas Healthcare Foundation Heb $291 132%
Texas Workforce Commission $307 139%
Curative Administrators $314 142%
Harbor Health Team $314 142%
Averde Health $354 160%
Comanche County $393 178%
National Choicecare $393 178%
Healthsmart Preferred Care $432 - $629 196%
Independent Medical Systems $432 196%
Physicians Cooperative Of Texas $432 196%
Prime Health $472 214%
First Health $495 - $565 224%
Coastal Comp Health Networks $511 232%
National Health Care $511 232%
Occunet $550 249%
Texas Municipal League $550 249%
Medcorp Southwest $590 267%
Rockport Healthcare Group $629 - $707 285%
Bce Emergis Corporation $707 320%
Beech Street $707 320%
Medical Control Network Solutions $707 320%
Multiplan $707 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals