Physical therapy (gait training)
Facility: Hancock Regional Hospital
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $111
- Cash Discount Price: $109
- vs. Medicare Baseline: 3.82x 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 382% of the Medicare baseline (a markup of 282%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $28 - $136 | 96% |
| Caresource Mcr Adv | $28 | 96% |
| Iu Health Mcr Adv | $28 | 96% |
| Triwest - All Plans | $28 | 96% |
| UnitedHealthcare | $28 - $136 | 96% |
| Va Ccn - All Plans | $28 | 96% |
| Allwell Mcr Adv - All Plans | $29 | 100% |
| Beech Street Mcr Adv | $29 | 100% |
| Communicare Mcr Adv - All Plans | $29 | 100% |
| Humana | $29 - $129 | 100% |
| Ambetter / Centene | $56 | 193% |
| Caresource Comm - All Other Plans | $70 | 241% |
| Iu Health-All Other Plans | $77 | 265% |
| Ascension - All Plans | $102 | 351% |
| Aetna | $103 - $136 | 354% |
| Cigna | $109 | 375% |
| Encore Encircle | $109 | 375% |
| Hancock Phys Network-All Plans | $109 | 375% |
| Unified Group Services- All Plans | $109 | 375% |
| Advantage Self Funded Ppo-All Other Plans | $112 | 385% |
| Healthmark/Healthchoice-All Plans | $112 | 385% |
| Sagamore-All Plans | $112 | 385% |
| Encore-All Other Plans | $116 | 399% |
| Consumers Life-All Plans | $120 | 413% |
| St Vincent Cmo-All Plans | $120 | 413% |
| Siho-All Plans | $122 | 420% |
| Great West-All Plans | $125 | 430% |
| Savility - All Plans | $125 | 430% |
| Cofinity/Ppom - All Plans | $126 | 434% |
| First Health/Coventry-All Plans | $128 | 440% |
| Mail Handlers-All Plans | $128 | 440% |
| Golden Rule Ins-All Plans | $129 | 444% |
| Indiana Health Network-All Plans | $129 | 444% |
| Phcs-All Plans | $129 | 444% |
| Beech Street Ppo - All Other Plans | $131 | 451% |
| Comm Hlth Alliance - All Plans | $132 | 454% |
| Multiplan-All Plans | $133 | 458% |
| Advantage Preferred Plus | $136 | 468% |
| Healthy Indiana Plan-All Plans | $136 | 468% |
| Mhs/Mdwise Mcaid-All Plans | $136 | 468% |
| Copps - All Plans | $280 | 964% |
| Pro Health - All Plans | $408 | 1404% |