CMS Price Transparency Data

Physical therapy (gait training)

Facility: Bayou Bend Health System

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $45
Cash Discount Price: $45
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Bayou Bend Health System is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.55x the Medicare baseline. Located in 1097 Northwest Blvd, Franklin, LA.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$45

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: $45 (155%)

Insurance Median: $45 (155%)

Cash: $45 (155% of Medicare)

Ins. Median: $45 (155% 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.

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
Tricare	$29	100%
UnitedHealthcare	$30 - $126	103%
Aetna	$32 - $44	110%
Blue Cross Blue Shield	$32 - $50	110%
Dignity Mcr Adv Ip/Op Only-All Plans	$32	110%
Humana	$32 - $42	110%
Sterling Hp Mcr Adv Ip/Op Only-All Plans	$32	110%
Verity Healthnet Mcr Adv Ip/Op Only	$32	110%
Wellcare Mcr Allwell Ip/Op Only-All Plans	$32	110%
Ambetter / Centene	$37	127%
Amerihealth Caritas Mcaid Ip/Op Only-All Plans	$45	155%
Cigna	$45	155%
La Health Mcaid Ip/Op Only	$45	155%
Verity Healthnet Mcaid Ip/Op Only	$45	155%
Diocese Of Lafaytte Ip/Op Only-All Plans	$48	165%
Gilsbar 360 Ip/Op Only-All Plans	$48	165%
Verity Healthnet Ip/Op Only-All Other Plans	$48	165%
Ccn/First Health Ip/Op Only-All Plans	$51	175%
Integrated Hp Multiplan Ip/Op Only-All Plans	$51	175%
Ppo Plus / Zelis Ip/Op Only-All Plans	$51	175%
Geha Ppo Ip/Op Only-All Plans	$54	186%
Usa Mco Ip/Op Only-All Plans	$54	186%
Galaxy Ip/Op Only-All Plans	$58	200%

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 $45.
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 Bayou Bend Health System 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.