CMS Price Transparency Data

Neurobehavioral status check

Facility: Memorial Medical Center

Billing Code: 96116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 96116
  • Insurance Median: $135
  • Cash Discount Price: $201
  • vs. Medicare Baseline: 0.61x Medicare
The contracted insurance negotiated median rate for a Neurobehavioral status check at Memorial Medical Center is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $201. Compared to the federal Medicare reimbursement reference rate of $220.6, this hospital’s rate is 0.61x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$201

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $201 (91%)
Insurance Median: $135 (61%)
Cash: $201 (91% of Medicare)
Ins. Median: $135 (61% 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
Ambetter / Centene $30 - $162 14%
Healthcare Highways-All Plans $60 - $386 27%
Prime Healthcare Services-All Plans $65 - $337 29%
Blue Cross Blue Shield $69 - $74 31%
Triwest Va Pccc-All Plans $70 - $132 32%
Amerigroup Mcr Adv-All Other Plans $72 - $135 33%
Care Improvement Plus - All Other Plans $72 - $135 33%
Care Improvement Plus Mcr $72 - $136 33%
Superior Allwell Mcr Adv-All Other Plans $72 - $135 33%
UnitedHealthcare $72 - $386 33%
Universal American Mcr-All Other Plans $72 - $135 33%
Humana $74 - $386 34%
Universal American Snp $75 - $142 34%
Corvel Work Comp-All Plans $78 - $410 35%
Independent Med Sys Ppo-All Plans $78 - $410 35%
Multiplan Mcr Adv $78 - $135 35%
Multiplan Phcs Ppo-All Other Plans $78 - $410 35%
Provider Select Ppo-All Plans $78 - $410 35%
Three Rivers Ppo-All Plans $78 - $410 35%
Usa Mso - All Plans $78 - $410 35%
Coventry First Hlth Hmo Ppo-All Other Plans $89 - $386 40%
Coventry First Hlth Mcr Adv $89 - $135 40%
Amerigroup Chip $92 - $231 42%
Amerigroup Star $92 - $231 42%
Amerigroup Star Kids $92 - $231 42%
Amerigroup Star Plus $92 - $231 42%
Comm Health Chip $92 - $231 42%
Comm Health Perinatal-All Other Plans $92 - $231 42%
Molina Chip/Star-All Plans $92 - $231 42%
Scott & White Chip/Star-All Plans $92 - $231 42%
Superior Chip/Star $92 - $231 42%
Texas Childrens Hp - All Plans $92 - $231 42%
Comm Health Mcaid Hmo $97 - $243 44%
Comm Health Star $97 - $243 44%
Galaxy Health Network-All Plans $104 - $410 47%
Capstar Health Network-All Plans $137 - $386 62%
Cigna $137 - $362 62%
Aetna $386 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals