CMS Price Transparency Data

Physical therapy (gait training)

Facility: Henry Ford Allegiance Health

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $27
  • Cash Discount Price: $38
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Henry Ford Allegiance Health is $27. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $38. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.93x the Medicare baseline. Located in 205 N East Ave, Jackson, MI.
Cash / Self-Pay
$38

Average discount available for prompt cash payment at this facility.

Insurance Median
$27

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: $38 (131%)
Insurance Median: $27 (93%)
Cash: $38 (131% of Medicare)
Ins. Median: $27 (93% 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
Aetna $15 - $90 52%
Blue Cross Blue Shield $15 - $56 52%
Hap Caresource $15 - $19 52%
Mclaren $15 52%
Meridian Health Plan Of Mi $15 - $41 52%
Priority Health $15 - $49 52%
Molina $16 - $27 55%
Mclaren Health Plan Inc. $19 - $27 65%
Meridian $19 65%
Priority $20 - $27 69%
Hap $23 - $86 79%
Humana $23 - $29 79%
Bcn $27 - $37 93%
Cca Health Mi $27 93%
Health Alliance Plan Of Michigan $27 93%
Thomas Pace $27 93%
Vaccn $28 96%
United Behavioral Health, Inc. $29 100%
Vitalcore Physicians Group Of Mi $35 - $70 120%
Cofinity $37 127%
Cigna $39 - $124 134%
Molina Mi Health Link $42 145%
Mclaren Health $70 241%
Jackson County Offiice Of The Sheriff $72 248%
Immergrun Inc $83 286%
UnitedHealthcare $103 354%
University Of Michigan $120 413%
Cofinity Group Health $125 430%
Frontpath $125 430%
Multiplan, Inc. $125 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 205 N East Ave, Jackson, MI 49201
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals