Physical therapy (gait training)
Facility: Dukes Memorial Hospital
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $58
- Cash Discount Price: $83
- vs. Medicare Baseline: 2.00x 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 |
|---|---|---|
| Blue Cross Blue Shield | $14 - $186 | 48% |
| Department Of Veterans Affairs | $14 - $47 | 48% |
| Humana | $14 - $186 | 48% |
| Iu Health Plan | $14 - $50 | 48% |
| Managed Health Services | $14 - $186 | 48% |
| Medicare (plans) | $14 - $50 | 48% |
| Tricare | $14 - $47 | 48% |
| UnitedHealthcare | $14 - $186 | 48% |
| Aetna | $15 - $120 | 52% |
| In Dept Of Correction | $15 - $52 | 52% |
| Miami County Sheriffs Department | $15 - $52 | 52% |
| Node Devoted Health Mcr Adv | $15 - $51 | 52% |
| Node Pphp Mcr Adv | $15 - $53 | 52% |
| Node Va | $15 - $122 | 52% |
| Lutheran Advanced Network | $22 - $76 | 76% |
| Lutheran Three Rivers Preferred Plus 150 | $22 - $76 | 76% |
| Node Lutheran Preferred Fixed 2 | $22 - $76 | 76% |
| Align Network | $23 - $81 | 79% |
| Lutheran Preferred | $23 - $202 | 79% |
| Encore Work Comp In | $26 - $91 | 89% |
| Lutheran Three Rivers Preferred Plus 175 | $26 - $88 | 89% |
| Prime Health Services | $26 - $189 | 89% |
| One Call Wc | $28 | 96% |
| Partners Direct Health Llc | $28 - $96 | 96% |
| Veterans Eval Services | $28 | 96% |
| Lutheran Northwest Health Preferred | $29 - $101 | 100% |
| Physicians Health Plan | $29 - $117 | 100% |
| Three Rivers Preferred Plus | $29 - $101 | 100% |
| Work Comp | $29 - $101 | 100% |
| Cigna | $31 - $252 | 107% |
| Three Rivers Preferred | $33 - $113 | 114% |
| Php Freedom | $34 - $116 | 117% |
| Encore Kba Epo | $35 - $121 | 120% |
| Amish Aid | $36 - $126 | 124% |
| Encore Ppo | $36 - $126 | 124% |
| Self Pay | $36 - $139 | 124% |
| Sagamore Health Network | $40 - $140 | 138% |
| Us Department Of Labor | $43 | 148% |
| Encore Kba Ppo | $44 - $151 | 151% |
| Consumer Life | $45 - $156 | 155% |
| First Health | $58 - $202 | 200% |
| Multiplan | $59 - $204 | 203% |
| Encore Health Network | $60 - $207 | 206% |
| Advantage Health Solutions | $61 - $209 | 210% |
| Encore | $66 - $227 | 227% |
| Caresource | $143 - $186 | 492% |
| Medicaid / KanCare | $186 | 640% |
| Mhs | $186 | 640% |