CMS Price Transparency Data

Physical therapy (gait training)

Facility: Munson Healthcare Grayling Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Munson Healthcare Grayling Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 1100 E Michigan Ave, Grayling, MI.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $87 (299%)
Insurance Median: $32 (110%)
Cash: $87 (299% of Medicare)
Ins. Median: $32 (110% 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.

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
Blue Cross Blue Shield $15 - $58 52%
Mclaren Health Plan $15 - $57 52%
Meridian $15 52%
Molina $15 - $30 52%
Priority Health $15 - $85 52%
UnitedHealthcare $15 - $61 52%
Aetna $25 - $77 86%
Cofinity $25 - $80 86%
Atrium King Centre Skilled Nursing Services $28 96%
Blue Care Network $28 96%
Hap (Health Alliance Plan) $28 - $82 96%
Humana $28 96%
Medicare (plans) $28 96%
Michigan Amish Medical Board $28 - $32 96%
Northern Michigan Mennonite Group $28 96%
Promedica $28 96%
Wellcare (Meridian) $28 96%
Wellspring Lutheran Services Skilling Nursing Services $28 96%
Provider Network Of America Group Health $39 - $87 134%
Cigna $41 - $85 141%
Asr/Physicians Care $42 - $82 145%
Nomi Health $45 - $82 155%
Employee Benefits Logistics $47 162%
Hospice Of Michigan $61 210%
Munson Hospice $71 - $852 244%
Medical Cost Savings Solution $82 282%
The Robbins Group And Regency Employee Benefits $82 282%
Wds Enterprise Group Planning $82 282%
First Health/Coventry Network $87 299%
Three Rivers Provider Network $87 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 E Michigan Ave, Grayling, MI 49738
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals