Physical therapy (gait training)
Facility: Satanta District Hospital, Clinics, & Ltcu
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $47
- Cash Discount Price: $59
- vs. Medicare Baseline: 1.62x 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 |
|---|---|---|
| Direct Benefit-All Plans | $16 | 55% |
| UnitedHealthcare | $19 - $65 | 65% |
| Berkley Net-All Plans | $26 | 89% |
| Meritain Health-All Plans | $29 | 100% |
| Aetna | $29 - $44 | 100% |
| Trustmark Health Benefits-All Plans | $29 | 100% |
| Ambetter / Centene | $31 | 107% |
| Axa Equitable - All Plans | $36 | 124% |
| Pinnacol-All Plans | $36 | 124% |
| Medi-Share-All Plans | $37 | 127% |
| Presbyterian-All Plans | $40 | 138% |
| Kasb Work Comp - All Plans | $42 | 145% |
| The Kempton Group Admin-All Plans | $45 | 155% |
| Gpha(Wppa)-All Other Plans | $46 | 158% |
| Auxiant - All Plans | $46 | 158% |
| Wppa- All Plans | $46 | 158% |
| Emc-All Plans | $47 | 162% |
| Providers Care Network- All Plans | $47 | 162% |
| Sisco-All Plans | $47 | 162% |
| Gpha Employee Benefit Plan | $47 | 162% |
| First Health -All Plans | $49 | 169% |
| Employee Benefit-All Plans | $49 | 169% |
| Regional Care(Wppa)-All Plans | $49 | 169% |
| Triangle-All Plans | $49 | 169% |
| One Call Physician-All Plans | $50 | 172% |
| Blue Cross Blue Shield | $51 | 175% |
| Christian Hospital Aid - All Plans | $52 | 179% |
| Tricare | $52 | 179% |
| Humana | $56 | 193% |
| Cigna | $57 | 196% |
| Luminare Health- All Plans | $57 | 196% |
| Coresource-All Plans | $58 | 200% |
| Deseret Mutual(Uhis)-All Plans | $58 | 200% |
| Vaccn-All Plans | $60 | 206% |
| Reserve National-All Plans | $62 | 213% |
| Wps Vapc-All Plans | $62 | 213% |
| Hma Llc-All Plans | $62 | 213% |
| Medicaid / KanCare | $65 | 224% |
Consumer Guidance & Cost Commentary
For the CPT code 97116, representing physical therapy gait training, the facility's cash median rate is $59.00, which is notably higher than the state of Kansas average of $47.00. While the facility's negotiated rates with insurance payers range from $16 to $65, the cash price may actually be more affordable for patients with high-deductible plans or those without insurance, as the cash rate is lower than many commercial negotiated amounts. To secure the best possible price, patients should verify their specific plan's allowed amount and ask the billing department about self-pay or prompt-pay discounts, which can further reduce the final cost.
This service is provided by Satanta District Hospital, a Critical Access Hospital in Satanta, KS, with a gross charge of $65.00. When evaluating the cost, it is important to compare rates against the Medicare benchmark of $29.06 rather than the facility's inflated chargemaster list. The facility's negotiated rate of $47.00 aligns with the state median, but patients should be aware that commercial rates often include administrative overhead that can inflate the baseline price. If you receive an itemized bill, review it carefully for unbundled codes or services not rendered, and request a full CPT-coded statement before making any payments to ensure accuracy.