CMS Price Transparency Data

Physical therapy (gait training)

Facility: Deaconess Henderson Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $36
  • Cash Discount Price: $54
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Deaconess Henderson Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.24x the Medicare baseline. Located in 1305 N Elm St, Henderson, KY.
Cash / Self-Pay
$54

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $54 (186%)
Insurance Median: $36 (124%)
Cash: $54 (186% of Medicare)
Ins. Median: $36 (124% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Aetna $15 - $174 52%
Humana $15 - $143 52%
Medicaid / KanCare $15 - $36 52%
UnitedHealthcare $15 - $115 52%
Wellcare Ky $15 - $26 52%
Blue Cross Blue Shield $17 - $29 58%
Ky Racing Health & Welfare Fund $18 - $52 62%
Self-Pay $18 - $54 62%
Wellcare Il $19 - $26 65%
Medicare (plans) $26 89%
Mhs Mco $26 89%
Molina Healthcare Of Ky $26 89%
Molina Healthcare Of Ky - Exchange $26 89%
Mytru Advantage $26 - $52 89%
Umwa $26 89%
Alliance Coal $28 - $41 96%
Caresource In $28 96%
Cigna $30 - $115 103%
Claimdoc $30 - $107 103%
Hopetrust $30 103%
Hstechnology $30 - $107 103%
Amish And Mennonite Of Western Ky $32 - $41 110%
Caresource In Marketplace $34 117%
Wellcare Ky Commercial Exchange $34 117%
Center Care Narrow $36 - $150 124%
Center Care Open Access $36 - $150 124%
Encircle/Encore Combined $36 - $104 124%
Encircle/Encore Prime $36 - $97 124%
Coventry National Network $40 - $143 138%
Webster County Detention Center $40 - $143 138%
Noncontracted $42 145%
First Health Network (Coventry) $43 - $152 148%
Healthlink $43 - $134 148%
Iu Health Plans $43 - $92 148%
Phcs/Multiplan $43 - $150 148%
Sagamore $43 - $158 148%
Henderson County Detention Center $45 - $161 155%
One Care $54 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1305 N Elm St, Henderson, KY 42420
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals