Physical therapy (gait training)
Facility: Via Christi Hospital Wichita St Teresa, Inc
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $28
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.96x 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 |
|---|---|---|
| Via Christi Research | $27 | 93% |
| Va | $27 | 93% |
| Humana | $27 | 93% |
| Saint Lukes Health Systems | $27 | 93% |
| Vc Hope | $27 | 93% |
| Medicare (plans) | $27 - $28 | 93% |
| Blue Cross Blue Shield | $28 | 96% |
| UnitedHealthcare | $28 - $77 | 96% |
| Corizon | $34 | 117% |
| Smarthealth | $38 | 131% |
| Medicaid / KanCare | $46 | 158% |
| Coventry City Of Wichita | $64 | 220% |
| Aetna | $92 | 317% |
Consumer Guidance & Cost Commentary
For the CPT code 97116, representing physical therapy gait training, the facility's negotiated rates range from $27 to $92 across 13 payers, with a median negotiated amount of $28.00. This facility is a voluntary non-profit church-owned hospital in Wichita, Kansas, and its pricing aligns closely with the state and county averages, as the lowest and highest negotiated rates for this service in the region are also $27 and $28, respectively. While some commercial payers like UnitedHealthcare show a wider range of $28 to $77, the majority of insurers, including Medicare, Blue Cross Blue Shield, and several Kansas-specific plans, cluster around the $27–$28 mark. For patients with high-deductible plans, it is important to note that cash-pay rates are not listed for this service, but patients should always inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payments can sometimes result in lower out-of-pocket costs compared to the insurance negotiated rates.
When reviewing your final invoice, ensure you request a full itemized bill rather than accepting a summary statement, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Since the Medicare benchmark for this service is $29.06, any commercial negotiated rate exceeding this amount reflects the standard administrative markup inherent in insurance contracts, which typically averages between 200% and 300% of the Medicare rate. If you receive a balance bill for the difference between the chargemaster and your insurance allowed amount, you may be protected under the No Surprises Act, which prohibits balance billing