CMS Price Transparency Data

Physical therapy (gait training)

Facility: Cameron Memorial Community Hospital Inc

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $108
Cash Discount Price: $83
vs. Medicare Baseline: 3.72x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Cameron Memorial Community Hospital Inc is $108. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.72x the Medicare baseline. Located in 416 E Maumee St, Angola, IN.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$108

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: $83 (286%)

Insurance Median: $108 (372%)

Cash: $83 (286% of Medicare)

Ins. Median: $108 (372% 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 372% of the Medicare baseline (a markup of 272%). 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
Blue Cross Blue Shield	$43 - $86	148%
Aetna	$44 - $119	151%
Humana	$44 - $119	151%
UnitedHealthcare	$44 - $108	151%
Caresource Indiana Of In	$48 - $51	165%
Managed Health Services	$48	165%
Mdwise	$48	165%
Plain Church Group Ministry	$54	186%
Centivo	$75	258%
Lucent	$75	258%
Phcs	$103	354%
Php	$104	358%
Sagamore Health Network	$106	365%
Signature Care	$114 - $121	392%
Three Rivers Preferred	$117	403%
Cigna	$119	409%
Coventry	$121	416%
Lutheran Preferred	$124	427%
Encore	$127	437%
Frontpath	$127	437%
Corvel	$128	440%

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 $83.
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 Cameron Memorial Community Hospital Inc 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.