CMS Price Transparency Data

Physical therapy (gait training)

Facility: The Medical Center of Aurora & South Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $30
  • Cash Discount Price: $356
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at The Medical Center of Aurora & South Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $356. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.03x the Medicare baseline. Located in 1501 S Potomac St, Aurora, CO.
Cash / Self-Pay
$356

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $356 (1225%)
Insurance Median: $30 (103%)
Cash: $356 (1225% of Medicare)
Ins. Median: $30 (103% 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
Aetna $26 - $188 89%
Blue Cross Blue Shield $26 - $264 89%
Bright Health $26 - $107 89%
Cigna $26 - $228 89%
Devoted Health $26 - $30 89%
Humana $26 - $30 89%
Mutual Of Omaha $26 - $30 89%
Rocky Mountain Health $26 - $30 89%
Total Longterm Care $26 - $30 89%
Triwest Health Alliance $26 - $30 89%
United $26 - $160 89%
Kaiser $27 - $126 93%
Wellcare $27 - $31 93%
Delaware Life Insurance $28 - $32 96%
Vail Health $54 186%
Colorado Program For Children With Special Needs $150 516%
Western Plains Community Health $232 798%
Multiplan $249 - $321 857%
Northcare $249 857%
Physician Health Partners $249 857%
Pinnacol Workers Comp $267 919%
Medical Development International $285 981%
Prime Health $321 1105%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1501 S Potomac St, Aurora, CO 80012
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals