CMS Price Transparency Data

Physical therapy (gait training)

Facility: Falmouth Hospital

Billing Code: 97116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$51
about 1.8× the $29 Medicare rate · typically $35–$56
modeled estimate · not a bill or quote
What this hospital charges insurers
$56
About the fair price
about $5 over the fair price · 1.9× Medicare
Medicare pays $29 Fair price $51 This hospital $56 Cash price $112 Hospital's list price $264

How we calculate the fair BaseRate →

How this hospital compares to other MA hospitals

Highest price of the 9 MA hospitals we have prices for — worth calling around.

Cheapest $30 Priciest $56

Black dot = this hospital, among the 9 MA hospitals with a price for this procedure. Full list below.

A fair price for a Physical therapy (gait training) is about $51 (about 1.8× the $29 Medicare rate). Falmouth Hospital charges insurers about $56, or about $112 in cash — about the fair price. Located in Falmouth, MA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

2 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield AetnaCignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $30 103%
Blue Cross Blue Shieldmajor $32 - $117 110%
Harvard Pilgrim $40 138%
UniCare $870 2994%
WellSense $79 272%
+ 4 smaller / regional plans $30 - $371

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Facility Profile & Credentials

  • Address: 67 & 100 Ter Heun Drive, Falmouth, MA 02540
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals