CMS Price Transparency Data

Physical therapy (gait training)

Facility: University of Alabama Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $133
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.58x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at University of Alabama Hospital is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.58x the Medicare baseline. Located in 619 South 19Th Street, Birmingham, AL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$133

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%)
Insurance Median: $133 (458%)
Ins. Median: $133 (458% 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 458% of the Medicare baseline (a markup of 358%). 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.

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
Viva $11 38%
Triwest $28 96%
University Of Alabama $72 - $112 248%
UnitedHealthcare $79 - $199 272%
Aetna $88 - $137 303%
Coventry $94 - $181 323%
North Alabama Managed Care $94 - $146 323%
Cigna $97 - $171 334%
Comp One $104 - $161 358%
Construction Claims Management $108 - $168 372%
Alamed $109 - $168 375%
Corvel $116 - $179 399%
Evolutions $116 - $202 399%
Healthcare Alliance $116 - $179 399%
Novanet $116 - $202 399%
Prime Health Services $116 - $202 399%
Select Value Care $116 - $179 399%
Starcare $116 - $179 399%
Tethys $116 - $179 399%
Multiplan $119 - $184 409%
Department Of Labor $123 - $190 423%
Geha $123 - $190 423%
Gulf Health Plans $123 - $190 423%
Heritage Summit Health $123 - $190 423%
Humana $123 - $190 423%
Mississippi Physicians $123 - $190 423%
Phifer $123 - $190 423%
Preferred Health Partnership $123 - $190 423%
Southern Nuclear $123 - $190 423%
Vantage Health Plan $123 - $190 423%
Galaxy Health Network $130 - $202 447%
National Provider Network $130 - $202 447%
North Mississippi Health Link $130 - $202 447%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 619 South 19Th Street, Birmingham, AL 35233
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals