Physical therapy (gait training)
Facility: Aspen Valley Hospital
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $130
- Cash Discount Price: $130
- vs. Medicare Baseline: 4.47x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 447% of the Medicare baseline (a markup of 347%). 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.
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 | $70 - $130 | 241% |
| Blue Cross Blue Shield | $70 - $120 | 241% |
| Humana | $70 - $124 | 241% |
| Medicare (plans) | $70 | 241% |
| Tricare | $70 - $130 | 241% |
| UnitedHealthcare | $70 - $130 | 241% |
| Veterans Administration [100068] | $70 | 241% |
| Cigna | $91 - $146 | 313% |
| Allied Benefit Systems [100015] | $124 | 427% |
| Geha [100039] | $124 | 427% |
| Healthscope [100157] | $124 | 427% |
| Aarp [100007] | $130 | 447% |
| Aig Travel [100255] | $130 | 447% |
| Aig [700029] | $130 | 447% |
| Ameriben [100266] | $130 | 447% |
| American Republic [100018] | $130 | 447% |
| Amtrust North America [700042] | $130 | 447% |
| Axa Travel [100256] | $130 | 447% |
| Bankers Life Casualty [100022] | $130 | 447% |
| Broadspire [700043] | $130 | 447% |
| Bupa Global [100257] | $130 | 447% |
| Ccmsi [700017] | $130 | 447% |
| Champ Va [500001] | $130 | 447% |
| Chp [300053] | $130 | 447% |
| Chubb Services [700054] | $130 | 447% |
| Companion Life Pivot Health [100258] | $130 | 447% |
| Corvel [700058] | $130 | 447% |
| Employee Benefit Management [100033] | $130 | 447% |
| Equitable Life [100160] | $130 | 447% |
| Esis Work Comp [700010] | $130 | 447% |
| Freedom Life Insurance Company [100158] | $130 | 447% |
| Gallagher Bassett Work Comp [700013] | $130 | 447% |
| Generic Commercial [109999] | $130 | 447% |
| Generic Other [509999] | $130 | 447% |
| Generic Travel Insurance [109998] | $130 | 447% |
| Generic Workers' Comp [709999] | $130 | 447% |
| Gerber Life Insurance [100265] | $130 | 447% |
| Global Excel [100259] | $130 | 447% |
| Gmmi [100260] | $130 | 447% |
| Hartford Work Comp [700055] | $130 | 447% |
| Harvard Pilgrim Healthcare [100241] | $130 | 447% |
| Health Net [100261] | $130 | 447% |
| Imagine 360 [100043] | $130 | 447% |
| Kaiser Permanente [100254] | $130 | 447% |
| Liberty Healthshare [100262] | $130 | 447% |
| Liberty Mutual Work Comp [700016] | $130 | 447% |
| Marriott Claim [700056] | $130 | 447% |
| Medi Share [100263] | $130 | 447% |
| Medicaid / KanCare | $130 | 447% |
| Mutual Of Omaha [100074] | $130 | 447% |
| Owcp [700057] | $130 | 447% |
| Physicians Mutual [100075] | $130 | 447% |
| Pinnacol Assurance Wc [700059] | $130 | 447% |
| Relations Insurance Kaiser [800004] | $130 | 447% |
| Sedgwick [700027] | $130 | 447% |
| Sentinel Security Life [100264] | $130 | 447% |
| Skico Ortho Alternative Payer [100163] | $130 | 447% |
| Transamerica [100097] | $130 | 447% |
| Travelers Work Comp [700028] | $130 | 447% |
| Tufts Health Plan [100268] | $130 | 447% |
| United American Insurance [100119] | $130 | 447% |
| Usaa Life Insurance Company [100155] | $130 | 447% |
| Wea [100120] | $130 | 447% |