Physical therapy (gait training)
Facility: Mat-Su Regional Medical Center
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $350
- Cash Discount Price: $200
- vs. Medicare Baseline: 12.04x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $29.06 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 1204% of the Medicare baseline (a markup of 1104%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $37 | 127% |
| Node Non Par Hospice Agree | $37 | 127% |
| Node Triwest | $37 | 127% |
| Node Va | $37 | 127% |
| Veterans Eval Services | $37 | 127% |
| Node Champva | $52 | 179% |
| Tricare | $52 | 179% |
| Medicaid / KanCare | $54 | 186% |
| Node Us Dept Of Labor | $58 | 200% |
| Self Pay | $150 - $250 | 516% |
| Ak Dept Of Corrections | $275 | 946% |
| Blue Cross Blue Shield | $280 - $305 | 964% |
| Hccmca | $300 | 1032% |
| Aetna | $320 | 1101% |
| Multiplan Phcs | $380 | 1308% |
| Moda Assurance | $395 | 1359% |
| Cigna | $396 | 1363% |
| Carlie Trans Grp | $425 | 1462% |
| UnitedHealthcare | $425 | 1462% |
| First Choice Health | $450 | 1549% |
| Multiplan Mpi | $455 | 1566% |
| Plan Vista Solutions | $465 | 1600% |
| Multiplan Wc | $475 | 1635% |
| One Health | $475 | 1635% |
| First Health Group | $480 | 1652% |
| Medical Control Network Solutions | $480 | 1652% |