Physical therapy (gait training)
Facility: Midstate Medical Center
Billing Code: 97116 (CPT)
This hospital's typical commercial price is $95 compared to the $55 fair price benchmark.
4-Star CMS clinical quality rating paired with 1.73× fair market pricing.
On the higher side — 6 of 8 other CT hospitals charge less.
Black dot = this hospital, among the 9 CT hospitals with a price for this procedure. Full list below.
A fair price for a Physical therapy (gait training) is about $55 (about 1.9× the $29 Medicare rate). Midstate Medical Center charges insurers about $95, or about $123 in cash — above the fair price. Located in Meriden, CT.
This price is above the fair BaseRate — you may be able to pay less
Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $55. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $30 | 103% |
| Blue Cross Blue Shieldmajor | $30 - $212 | 103% |
| Aetnamajor | $30 - $210 | 103% |
| Cignamajor | $226 | 778% |
| Molina | $30 - $233 | 103% |
| Tufts Health Plan | $30 | 103% |
| WellCare | $30 | 103% |
| + 1 smaller / regional plan | $30 |
Self-Pay How to get the cash price
Insurance Before you use insurance
Estimate your out-of-pocket cost
A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.
Other Procedures at Midstate Medical Center
Compare: Physical therapy (gait training) at other CT hospitals
- Gaylord Hospital · Wallingford $30
- Bristol Hospital · Bristol $32
- St Francis Hospital & Medical Center · Hartford $33
- Saint Mary's Hospital · Waterbury $35
- John Dempsey Hospital of the University of Connect · Farmington $46
- Connecticut Childrens Medical Center · Hartford $72
- Windham Community Memorial Hospital · Willimantic $96
- The Hospital of Central Connecticut · New Britain $98
Insurance negotiated median for the same procedure, sorted lowest first.
Audit a Bill or Quote at Midstate Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $45
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (36.3% of gross = $45).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Midstate Medical Center's published 45 CFR § 180 self-pay cash rate is $123 (vs. $95 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $55 Fair BaseRate ($29 Medicare)
Your bill ($123) is $68 above the denoised Fair BaseRate ($55) and 4.2× the $29 Medicare rate.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare. Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.