CMS Price Transparency Data

Physical therapy (gait training)

Facility: Penobscot Valley Hospital

Billing Code: 97116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$63
about 2.2× the $29 Medicare rate · typically $38–$86
modeled estimate · not a bill or quote
What this hospital charges insurers
$93
Above the fair price
about $30 over the fair price · 3.2× Medicare
Medicare pays $29 Fair price $63 This hospital $93 Cash price $135 Hospital's list price $169

How we calculate the fair BaseRate →

How this hospital compares to other ME hospitals

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

Cheapest $27 Priciest $93

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

A fair price for a Physical therapy (gait training) is about $63 (about 2.2× the $29 Medicare rate). Penobscot Valley Hospital charges insurers about $93, or about $135 in cash — above the fair price. Located in Lincoln, ME.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $63. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser 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 $45 - $291 155%
Blue Cross Blue Shieldmajor $46 - $172 158%
Aetnamajor $46 - $349 158%
Cignamajor $92 - $341 317%
Humanamajor $46 - $169 158%
Harvard Pilgrim $94 - $347 323%
WellCare $46 - $169 158%
Government programs also on file: Medicare.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

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Facility Profile & Credentials

  • Address: 7 Transalpine Road, Po Box 368, Lincoln, ME 04457
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals