CMS Price Transparency Data

Physical therapy (gait training)

Facility: Community Health Network Rehabilitation Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $138
Cash Discount Price: $138
vs. Medicare Baseline: 4.75x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Community Health Network Rehabilitation Hospital is $138. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $138. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.75x the Medicare baseline. Located in 7343 Clearvista Dr, Indianapolis, IN.

Cash / Self-Pay

$138

Average discount available for prompt cash payment at this facility.

Insurance Median

$138

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: $138 (475%)

Insurance Median: $138 (475%)

Cash: $138 (475% of Medicare)

Ins. Median: $138 (475% 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 475% of the Medicare baseline (a markup of 375%). 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
Encore	$65 - $153	224%
UnitedHealthcare	$69 - $239	237%
Encore Combined	$71 - $167	244%
Parkview Signature Care	$81 - $191	279%
Aetna	$102 - $239	351%
Allwell From Mhs	$102 - $239	351%
Ambetter / Centene	$102 - $239	351%
Blue Cross Blue Shield	$102 - $239	351%
Caresource Hip-Mcd	$102 - $239	351%
Caresource Marketplace	$102 - $239	351%
Cigna	$102 - $239	351%
Community Health Direct	$102 - $239	351%
Humana	$102 - $239	351%
Medicaid / KanCare	$102 - $239	351%
Medicare (plans)	$102 - $239	351%
Mhs Hip-Mcd	$102 - $239	351%
Mytru Advantage	$102 - $239	351%

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 $138.
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 Community Health Network Rehabilitation Hospital 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.