Physical therapy (gait training)
Facility: Cambridge Health Alliance
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $63
- Cash Discount Price: $63
- vs. Medicare Baseline: 2.17x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Wc [90001] | $27 | 93% |
| Health Plans Inc [20002] | $35 - $312 | 120% |
| Hphc [20001] | $35 - $312 | 120% |
| UnitedHealthcare | $35 - $312 | 120% |
| Cigna | $37 - $184 | 127% |
| Mass General Brigham [50021] | $40 | 138% |
| Aarp [40001] | $41 - $188 | 141% |
| Oxford Health [40004] | $41 - $188 | 141% |
| United Medical Resource [40005] | $41 - $188 | 141% |
| Aetna | $42 - $63 | 145% |
| Multiplan [50010] | $43 | 148% |
| Wellpoint [50012] | $48 | 165% |
| Other Tufts Health Public Plan [75002] | $55 | 189% |
| Altus Dental [99011] | $63 | 217% |
| Beacon Health Strategies [50002] | $63 | 217% |
| Blue Cross Blue Shield | $63 - $105 | 217% |
| Cbhc Uninsured Crisis Alt Payer [70097] | $63 | 217% |
| Cbhc Uninsured Crisis [70096] | $63 | 217% |
| Celticare [50004] | $63 | 217% |
| Commonwealth Care Alliance Dental [99004] | $63 | 217% |
| Coverage Discovery [90004] | $63 | 217% |
| Delta Dental Of Ma [99007] | $63 | 217% |
| Dominion National Dental [99012] | $63 | 217% |
| Dph Tb Payor [85004] | $63 | 217% |
| Esp Dental [99003] | $63 | 217% |
| Eyemed Alt Payor [13001] | $63 | 217% |
| First Health [50007] | $63 | 217% |
| Global Medical Management [50024] | $63 | 217% |
| Government Employee Health Association [50023] | $63 | 217% |
| Guardian Dental [99013] | $63 | 217% |
| Health Safety Net Dental [99002] | $63 | 217% |
| Humana | $63 | 217% |
| Ma Laborers Health And Welfare Fund [50022] | $63 | 217% |
| Magellan Health Services [65098] | $63 | 217% |
| Mass Health Dental [99001] | $63 | 217% |
| Medical Mutual Of Ohio [50019] | $63 | 217% |
| Medicare (plans) | $63 | 217% |
| Metlife Dental [99008] | $63 | 217% |
| Modern Assistance Program [30098] | $63 | 217% |
| Mva [90002] | $63 | 217% |
| Neighborhood Health Plan [50011] | $63 | 217% |
| Other Bh Payor [50014] | $63 | 217% |
| Other Commercial Payor [50015] | $63 | 217% |
| Other Dental Payor [99014] | $63 | 217% |
| Other Dual Eligible Payer [65004] | $63 | 217% |
| Other Gov'T Alt [85006] | $63 | 217% |
| Other Vision Payor [50013] | $63 | 217% |
| Ri Neighborhood Health Plan [50017] | $63 | 217% |
| Tricare | $63 | 217% |
| Tufts Health Plan [30001] | $91 - $107 | 313% |