Physical therapy (gait training)
Facility: Oro Valley Hospital
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $43
- Cash Discount Price: $75
- vs. Medicare Baseline: 1.48x 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.
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 |
|---|---|---|
| Aetna | $28 - $166 | 96% |
| Caremore Health Plan | $28 | 96% |
| Cigna | $28 - $236 | 96% |
| Department Of Veterans Affairs | $28 | 96% |
| Humana | $28 | 96% |
| Medicare (plans) | $28 | 96% |
| Pascua Yaqui Tribe | $28 | 96% |
| Scan Health | $28 | 96% |
| Tricare | $28 | 96% |
| UnitedHealthcare | $28 - $185 | 96% |
| Veterans Eval Services | $28 | 96% |
| Blue Cross Blue Shield | $29 - $115 | 100% |
| Clover Health Mcr Adv | $29 | 100% |
| Fresenius Health | $29 | 100% |
| Node Devoted Health Mcr Adv | $29 | 100% |
| Node Non Par Hospice Agree | $29 | 100% |
| Node Triwest | $29 | 100% |
| Node Va | $29 | 100% |
| Magellan | $30 - $137 | 103% |
| Node Banner Mcr Adv | $30 | 103% |
| Wellcare Mcr Adv | $30 | 103% |
| Medicaid / KanCare | $33 - $35 | 114% |
| Ambetter / Centene | $40 | 138% |
| Node Us Dept Of Labor | $42 | 145% |
| Node Health Choice Exchange | $43 | 148% |
| Node Fusion Network | $51 | 175% |
| Node J Allen Inmate Health Svcs | $54 | 186% |
| Self Pay | $55 - $96 | 189% |
| Health Net | $60 | 206% |
| Seven Corners | $66 | 227% |
| Beacon Health Options | $114 | 392% |
| Mtc | $114 | 392% |
| First Health Coventry | $120 | 413% |
| Coventry Work Comp Al | $137 | 471% |
| Multiplan | $189 | 650% |
| Prime Health | $194 | 668% |
| Three Rivers | $194 | 668% |
| Healthsmart | $205 | 705% |