CMS Price Transparency Data

Physical therapy (gait training)

Facility: Alaska Regional Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $290
Cash Discount Price: $536
vs. Medicare Baseline: 9.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Alaska Regional Hospital is $290. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $536. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 9.98x the Medicare baseline. Located in 2801 Debarr Road, Anchorage, AK.

Cash / Self-Pay

$536

Average discount available for prompt cash payment at this facility.

Insurance Median

$290

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)

Cash / Self-Pay: $536 (1844%)

Insurance Median: $290 (998%)

Cash: $536 (1844% of Medicare)

Ins. Median: $290 (998% of 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 998% of the Medicare baseline (a markup of 898%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Triwest Healthcare Alliance	$33 - $37	114%
United	$33 - $404	114%
Veteran'S Administration	$33 - $37	114%
Veterans Evaluation Services	$41 - $47	141%
Union Coalition	$158	544%
Union Coalition Cement Masons	$164	564%
Moda Health	$171 - $252	588%
Premerafirst	$265	912%
Geha Ppo Usa	$276 - $469	950%
Cigna	$290	998%
Multiplan	$321 - $498	1105%
Coventry Healthcare	$337	1160%
First Health	$375	1290%
Bering Strait School District	$402	1383%
Nreca Group Benefit Trust	$402	1383%
Risk & Benefit Management	$402	1383%
Banner Health	$429	1476%
Matanuska Telephone	$429	1476%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $536.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Alaska Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.