CMS Price Transparency Data

Physical therapy (gait training)

Facility: Banner Payson Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $17
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Banner Payson Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $17. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 807 South Ponderosa Drive, Payson, AZ.
Cash / Self-Pay
$17

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $17 (58%)
Insurance Median: $32 (110%)
Cash: $17 (58% of Medicare)
Ins. Median: $32 (110% 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.

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
Arizona Physicians Ipa $17 - $30 58%
Health Net $17 - $44 58%
Mercy Care $17 - $30 58%
Aetna $30 - $81 103%
Banner Health $30 103%
Banner University Health Plan $30 103%
Blue Cross Blue Shield $30 - $143 103%
Care 1St $30 103%
Cigna $30 - $57 103%
Gila River Health Care Corporation $30 103%
Health Choice Arizona, Inc. $30 - $42 103%
Kaiser Foundation Health Plan $30 103%
Triwest Healthcare Alliance Corp - Va Ccn $30 103%
UnitedHealthcare $30 - $48 103%
Upmc Health Plan $30 103%
Wellpoint $30 103%
Carelon $31 107%
Humana $31 107%
Arizona Priority Care $32 110%
Devoted Health Services $32 110%
Gold Kidney Health Plan $32 110%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi) $32 110%
Plotkin Health $32 110%
Oscar Health Plan $49 169%
Quiktrip Corporation $50 172%
Arizona Medical Network $65 224%
Provider Network Of America $65 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 807 South Ponderosa Drive, Payson, AZ 85541
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals