CMS Price Transparency Data

Physical therapy (gait training)

Facility: Memorial Health Meadows Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $28
  • Cash Discount Price: $214
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Memorial Health Meadows Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in One Meadows Parkway, Vidalia, GA.
Cash / Self-Pay
$214

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $214 (736%)
Insurance Median: $28 (96%)
Cash: $214 (736% of Medicare)
Ins. Median: $28 (96% 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
Ambetter / Centene $16 - $31 55%
Blue Cross Blue Shield $24 - $110 83%
Devoted Health $24 - $28 83%
Eon Health Dme $24 - $28 83%
Humana $24 - $28 83%
Vidalia Health $24 - $28 83%
Aetna $25 - $28 86%
Healthspring $25 - $28 86%
United $25 - $96 86%
Wellcare $25 - $28 86%
Amerigroup $26 89%
Clover $26 - $29 89%
Eon Health $26 - $29 89%
Georgia Assurance $26 - $29 89%
Shared Health $26 - $29 89%
Friday Health $32 110%
Pruitt Health $41 141%
Peach State $43 148%
Memorial Health Plan $47 - $96 162%
Centurion $59 203%
Cigna $77 265%
Health One Alliance $98 337%
Multiplan $192 661%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Meadows Parkway, Vidalia, GA 30474
  • CMS Rating: ★★★★★
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals