CMS Price Transparency Data
Physical therapy (gait training)
Facility: Trinity Health Ann Arbor Hospital
Billing Code: 97116 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97116
- Insurance Median: $114
- Cash Discount Price: $96
- vs. Medicare Baseline: 3.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Trinity Health Ann Arbor Hospital is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.92x the Medicare baseline. Located in 5301 E Huron River Dr, Ann Arbor, MI.
Cash / Self-Pay
$96
Average discount available for prompt cash payment at this facility.
Insurance Median
$114
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: $96 (330%)
Insurance Median: $114 (392%)
Cash: $96 (330% of Medicare)
Ins. Median: $114 (392% 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 392% of the Medicare baseline (a markup of 292%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 | $16 - $53 | 55% |
| Medicaid / KanCare | $16 | 55% |
| Aetna | $28 - $83 | 96% |
| Blue Care Network Advantage | $28 | 96% |
| Huron Valley Pace | $28 | 96% |
| Medicare (plans) | $28 - $29 | 96% |
| Align Senior Care | $29 | 100% |
| Angela Hospice | $29 | 100% |
| Hospice Advantage | $29 | 100% |
| UnitedHealthcare | $30 - $133 | 103% |
| Cca - Zing Health | $31 | 107% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $33 | 114% |
| Point Comfort Underwriters | $37 | 127% |
| Molina Marketplace | $38 | 131% |
| Health Cost Solutions | $43 | 148% |
| Wc Accident Fund | $43 | 148% |
| Wc Advantage | $43 | 148% |
| Wc Aig | $43 | 148% |
| Wc Allied | $43 | 148% |
| Wc Amerisure | $43 | 148% |
| Wc Amtrust | $43 | 148% |
| Wc Asu Risk Mgt | $43 | 148% |
| Wc Berkley Admin | $43 | 148% |
| Wc Broadspire | $43 | 148% |
| Wc Bunch & Associates | $43 | 148% |
| Wc Ccmsi | $43 | 148% |
| Wc Emc Insurance Company | $43 | 148% |
| Wc Esis | $43 | 148% |
| Wc Fcci | $43 | 148% |
| Wc Federated | $43 | 148% |
| Wc Gallagher Bassett | $43 | 148% |
| Wc Genex Care For Ohio | $43 | 148% |
| Wc Guard Insurance Company | $43 | 148% |
| Wc Hartford | $43 | 148% |
| Wc Liberty Mutual | $43 | 148% |
| Wc Meijers | $43 | 148% |
| Wc Michigan | $43 | 148% |
| Wc Mitchell Frankenmuth | $43 | 148% |
| Wc Pma | $43 | 148% |
| Wc Sedgwick | $43 | 148% |
| Wc Sentry | $43 | 148% |
| Wc Travelers | $43 | 148% |
| Wc Tristar | $43 | 148% |
| Wc Walmart | $43 | 148% |
| Wc Zurich | $43 | 148% |
| Wellpath | $43 - $45 | 148% |
| U Of M Health Plan | $44 | 151% |
| Vitalcore | $45 | 155% |
| Priority Health | $49 - $55 | 169% |
| Bcn Domestic | $53 | 182% |
| Blue Benefit Administrators Of Massachusetts | $53 | 182% |
| Blue Care Network | $53 | 182% |
| Blue Distinction Transplant | $53 | 182% |
| Blue Shield - Ca | $53 | 182% |
| Blue Shield - Id (Regence) | $53 | 182% |
| Blue Shield - Ny Highmark Northeastern | $53 | 182% |
| Blue Shield - Ny Highmark Western | $53 | 182% |
| Blue Shield - Pa (Highmark) | $53 | 182% |
| Blue Shield - Wa (Regence) | $53 | 182% |
| Health Choices | $53 - $114 | 182% |
| Kaiser Domestic | $53 | 182% |
| Asr Health Benefits | $65 | 224% |
| Caresource | $65 | 224% |
| Employee Benefit Logistic | $65 | 224% |
| Hap | $65 - $114 | 224% |
| Varipro | $65 | 224% |
| Acs Benefit Services | $69 | 237% |
| Allied Benefit Systems | $69 | 237% |
| Claimchoice Adminstrators | $69 | 237% |
| Consociate | $69 | 237% |
| Cypress Benefit Administrators | $69 | 237% |
| Forest County Potawatomi | $69 | 237% |
| Health Smart | $69 | 237% |
| Healthgram | $69 | 237% |
| Healthscope | $69 | 237% |
| Secureone Preferred United Plans | $69 | 237% |
| Sisco Benefits | $69 | 237% |
| The Health Plan | $69 | 237% |
| Trustmark Small Business Benefits | $69 | 237% |
| Unified Group Services | $69 | 237% |
| Webtpa | $69 | 237% |
| Geha | $83 - $108 | 286% |
| Meritain | $83 | 286% |
| 1199 National Benefit Fund | $114 | 392% |
| Access Health | $114 | 392% |
| Acclaim | $114 | 392% |
| Administrative Concepts | $114 | 392% |
| Allegeant | $114 | 392% |
| Allied National Global Care | $114 | 392% |
| Ameriben | $114 | 392% |
| American Family | $114 | 392% |
| American Healthcare Alliance | $114 | 392% |
| American National | $114 | 392% |
| American Republic | $114 | 392% |
| Amerihealth | $114 | 392% |
| Asrm - Reliance Standard Life Insurance | $114 | 392% |
| Aultcare | $114 | 392% |
| Automated Benefit Services | $114 | 392% |
| Auxiant | $114 | 392% |
| Benefit Administrative Systems,Llc | $114 | 392% |
| Boon Chapman | $114 | 392% |
| Cam Administrative Services | $114 | 392% |
| Christian Brother Services | $114 | 392% |
| Christian Brothers Holy Cross | $114 | 392% |
| Christian Care Ministry | $114 | 392% |
| Comprehensive Benefits | $114 | 392% |
| Continental Life Insurance | $114 | 392% |
| Coventry | $114 | 392% |
| Custom Benefit Administrators | $114 | 392% |
| Dean Health | $114 | 392% |
| Employee Benefit Concepts | $114 | 392% |
| Employee Benefit Management | $114 | 392% |
| Enterprise Group Planning | $114 | 392% |
| Fallon Health | $114 | 392% |
| Family Life Insurance Company | $114 | 392% |
| Freedom Life Insurance Company | $114 | 392% |
| Ghc Scw | $114 | 392% |
| Group Administrators | $114 | 392% |
| Group Marketing Services | $114 | 392% |
| Group Pension Administrators | $114 | 392% |
| Guardian | $114 | 392% |
| Health America | $114 | 392% |
| Health Partners | $114 | 392% |
| Healthcare Management Admin | $114 | 392% |
| Healthez | $114 | 392% |
| Humana | $114 | 392% |
| Insight | $114 | 392% |
| Intercare | $114 | 392% |
| International Benefit Administrators | $114 | 392% |
| Jfp Benefit Management | $114 | 392% |
| Jp Farley Corporation | $114 | 392% |
| Key Benefit Administrator | $114 | 392% |
| Liberty Union Life Assurance Co | $114 | 392% |
| Lifetime Benefit Solutions | $114 | 392% |
| Lucent Health | $114 | 392% |
| Luminare Health | $114 | 392% |
| Luminare Health (Detroit) | $114 | 392% |
| Magnacare | $114 | 392% |
| Manhattan Life | $114 | 392% |
| Medben | $114 | 392% |
| Medcost | $114 | 392% |
| Medi Share | $114 | 392% |
| Medical Mutual | $114 | 392% |
| Multiplan | $114 | 392% |
| Mutual Health Services | $114 | 392% |
| Mutual Of Omaha | $114 | 392% |
| Mvp | $114 | 392% |
| Ncas | $114 | 392% |
| Nippon Life Ins | $114 | 392% |
| Nova | $114 | 392% |
| Pai | $114 | 392% |
| Painters Union Insurance Fund | $114 | 392% |
| Pan-American Life | $114 | 392% |
| Paramount Hmo | $114 | 392% |
| Phcs | $114 | 392% |
| Physicians Mutual | $114 | 392% |
| Plumbers Local 98 Insurance Fund | $114 | 392% |
| Prairie States | $114 | 392% |
| Preferred One | $114 | 392% |
| Primary Physician Care | $114 | 392% |
| Professional Benefit Administrators | $114 | 392% |
| Siho Insurance Services | $114 | 392% |
| The Loomis Company | $114 | 392% |
| Trinity Health Share | $114 | 392% |
| Tufts Health Plan | $114 | 392% |
| Unicare | $114 | 392% |
| Us Health And Life | $114 | 392% |
| Valenz | $114 | 392% |
| Western & Southern Financial Group | $114 | 392% |
| Wps | $114 | 392% |
| Cigna | $115 | 396% |
| First Health | $117 | 403% |
| Prime Health Services | $118 | 406% |
| Correctional Healthcare Consultants | $133 | 458% |
| Three Rivers Provider Network | $133 | 458% |
| Bcccp-Michigan | $148 | 509% |
| Cmh Detroit Wayne Integrated Health Network | $148 | 509% |
| Cmh Lenawee County | $148 | 509% |
| Cmh Livingston County | $148 | 509% |
| Cmh Misc | $148 | 509% |
| Cmh Monroe County | $148 | 509% |
| Cmh Washtenaw County | $148 | 509% |
| Crime Victim Assistance | $148 | 509% |