Physical therapy (gait training)
Facility: Lost Rivers Medical Center
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $52
- Cash Discount Price: $64
- vs. Medicare Baseline: 1.79x 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.
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 |
|---|---|---|
| Select Health Brightpath-All Other Plans | $45 | 155% |
| Tricare | $45 | 155% |
| Ihcn Brightpath-All Other Plans | $48 | 165% |
| Va Pccc-All Plans | $49 | 169% |
| Blue Cross Blue Shield | $50 - $80 | 172% |
| Humana | $50 - $80 | 172% |
| Ihcn Brightpath Mcr Adv | $50 | 172% |
| Molina Mcr Adv-All Plans | $50 | 172% |
| Pacificsource Mcr Adv | $50 | 172% |
| Provider Network Of America-All Plans | $50 | 172% |
| Regence/Brightpth Slhp Mcr | $50 | 172% |
| Select Health Mcr Adv | $50 | 172% |
| Prime Hlth Mcr Adv | $53 | 182% |
| Aetna | $54 - $75 | 186% |
| Cigna | $74 | 255% |
| First Choice-All Plans | $74 | 255% |
| Pacificsource Navigator-All Other Plans | $76 | 262% |
| UnitedHealthcare | $76 | 262% |
| Altius Health Plan-All Plans | $78 | 268% |
| Regence Blue Shield-All Other Plans | $78 | 268% |