CMS Price Transparency Data

Physical therapy (gait training)

Facility: Munson Healthcare Cadillac Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $36
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Munson Healthcare Cadillac Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.24x the Medicare baseline. Located in 400 Hobart St, Cadillac, MI.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $84 (289%)
Insurance Median: $36 (124%)
Cash: $84 (289% of Medicare)
Ins. Median: $36 (124% 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 - $51 52%
Mclaren Health Plan $15 - $62 52%
Meridian $15 52%
Molina $15 - $30 52%
Priority Health $15 - $85 52%
UnitedHealthcare $15 - $61 52%
Aetna $25 - $75 86%
Cofinity $25 - $77 86%
American Health Associates $28 96%
Autumnwood Of Mcbain Skilled Nursing $28 96%
Blue Care Network $28 96%
Hap (Health Alliance Plan) $28 - $79 96%
Humana $28 96%
Medicare (plans) $28 96%
Michigan Amish Medical Board $28 96%
Promedica $28 96%
Samaritas Senior Living Skilled Nursing $28 96%
Wellcare (Meridian) $28 96%
Provider Network Of America Group Health $39 - $84 134%
Cigna $41 - $85 141%
Asr/Physicians Care $42 - $79 145%
Employee Benefits Logistics $47 162%
Hospice Of Michigan $59 203%
Munson Hospice $69 - $852 237%
Enterprise Group Planning/Employee Benefit Plan $79 272%
Medical Cost Savings Solution $79 272%
Nomi Health $79 272%
Robbing Group And Regency Employee Benefits $79 272%
First Health/Coventry Network $84 289%
Three Rivers Provider Network $84 289%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 Hobart St, Cadillac, MI 49601
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals