Physical therapy (gait training)
Facility: Deaconess Hospital Inc
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $43
- Cash Discount Price: $59
- vs. Medicare Baseline: 1.48x 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 |
|---|---|---|
| Aetna | $15 - $101 | 52% |
| Humana | $15 - $45 | 52% |
| Medicaid / KanCare | $15 - $45 | 52% |
| UnitedHealthcare | $15 - $251 | 52% |
| Ky Racing Health & Welfare Fund | $18 - $59 | 62% |
| Self-Pay | $18 - $59 | 62% |
| Blue Cross Blue Shield | $19 - $28 | 65% |
| Meridiancomplete (Il) | $19 | 65% |
| Meridianhealth (Il) | $19 | 65% |
| Youthcare (Meridian Il) | $19 | 65% |
| Youthcare (Wellcare Il) | $19 | 65% |
| Mhnet | $22 | 76% |
| United Behavioral Health | $25 | 86% |
| Caresource In | $28 | 96% |
| Medicare (plans) | $28 | 96% |
| Meridiancare (Il) | $28 | 96% |
| Molina (Il) Mmai | $28 | 96% |
| Molina Il | $28 | 96% |
| Mytru Advantage | $28 | 96% |
| Triwest Vapc3 | $28 | 96% |
| Wellcare (Il) Mmai | $28 | 96% |
| Alliance Coal | $29 - $54 | 100% |
| Chamber Care | $30 - $107 | 103% |
| Ambetter / Centene | $34 - $107 | 117% |
| Parkview Signature Care | $34 - $122 | 117% |
| Caresource In Marketplace | $36 | 124% |
| Center Care Narrow Select | $36 - $106 | 124% |
| Center Care Open Access | $36 - $115 | 124% |
| Encircle/Encore Combined | $36 - $93 | 124% |
| Encircle/Encore Elite+ | $36 - $89 | 124% |
| Encircle/Encore Prime | $36 - $84 | 124% |
| Patoka Valley Health Care (80/20 Plan) | $36 - $90 | 124% |
| Patoka Valley Health Care (90/10 Plan) | $36 - $90 | 124% |
| Healthlink | $38 - $152 | 131% |
| Allied National | $39 - $107 | 134% |
| Claimdoc | $39 - $107 | 134% |
| Healthscope | $39 - $107 | 134% |
| Deaconess Onecare | $41 - $89 | 141% |
| Hopetrust | $41 - $107 | 141% |
| Hstechnology | $41 - $107 | 141% |
| Iu Health Network | $41 - $92 | 141% |
| Cigna | $43 - $125 | 148% |
| Claritev (Formerly Phcs Multiplan) | $43 - $109 | 148% |
| First Health | $43 - $132 | 148% |
| Sagamore (Ppo, Oap-Open Access Plus, Epo, Choice Fund Oap+) | $43 - $115 | 148% |
| National Rural Electric | $44 - $158 | 151% |
| Noncontracted | $44 | 151% |
| Naphcare | $45 | 155% |
| Immergrun | $75 | 258% |