CMS Price Transparency Data

Physical therapy (gait training)

Facility: Steele Memorial Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $88
Cash Discount Price: $71
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Steele Memorial Medical Center is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.03x the Medicare baseline. Located in 203 South Daisy Street, Salmon, ID.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $71 (244%)

Insurance Median: $88 (303%)

Cash: $71 (244% of Medicare)

Ins. Median: $88 (303% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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	$42 - $89	145%
Pacific Source Mcr Adv	$44	151%
Windsor Hp Mcr Adv - All Plans	$44	151%
Blue Cross Blue Shield	$45 - $94	155%
Select Health Mcr Adv	$45	155%
Liberty Healthshare - All Plans	$75	258%
Pacific Source - All Other Plans	$85	292%
Cigna	$87	299%
Mountain Health Co-Op - All Plans	$89	306%
Regence Blue Shield - All Plans	$89	306%
Select Health Inc - All Other Plans	$89	306%
UnitedHealthcare	$89	306%
Multiplan - All Plans	$92	317%
Three Rivers - All Plans	$92	317%
Ichn, Llc - All Plans	$94	323%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $71.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Steele Memorial Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.