CMS Price Transparency Data

Physical therapy (gait training)

Facility: Bienville Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $422
  • Cash Discount Price: $469
  • vs. Medicare Baseline: 14.52x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Bienville Medical Center is $422. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $469. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 14.52x the Medicare baseline. Located in 1175 Pine Street, Arcadia, LA.
Cash / Self-Pay
$469

Average discount available for prompt cash payment at this facility.

Insurance Median
$422

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: $469 (1614%)
Insurance Median: $422 (1452%)
Cash: $469 (1614% of Medicare)
Ins. Median: $422 (1452% 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 1452% of the Medicare baseline (a markup of 1352%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $9 - $936 31%
Medicaid / KanCare $9 - $55 31%
Mmd Amerihealth Caritas $9 - $55 31%
Mmd Healthy Blue $9 - $55 31%
Mmd La Hlth Conn $9 - $55 31%
Mmd Misc $9 - $55 31%
UnitedHealthcare $9 - $505 31%
Cashiering $62 - $562 213%
Cigna $78 - $468 268%
Ambetter / Centene $84 - $505 289%
Humana $84 - $604 289%
Mcr American Hlth Adv $84 - $505 289%
Medicare (plans) $84 - $505 289%
Misc Mgd Care $84 - $936 289%
Mmc Blue Advantage $84 - $505 289%
Mmc Misc $84 - $505 289%
Peoples Health Mcr Adv $84 - $505 289%
Va Health $84 - $505 289%
Blue Cross Blue Shield $94 - $563 323%
Wc City Of Arcadia $140 - $842 482%
Wc House Of Raeford $140 - $842 482%
Wc Misc $140 - $842 482%
Wc Stonetrust $140 - $842 482%
Aarp $156 - $936 537%
Allegiance Health Managme $156 - $936 537%
Amfirst $156 - $936 537%
Apwu $156 - $936 537%
Liberty Mutual $156 - $936 537%
Misc Comm A-L $156 - $936 537%
Misc Comm M-Z $156 - $936 537%
Tricare $156 - $936 537%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1175 Pine Street, Arcadia, LA 71001
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals