CMS Price Transparency Data

Physical therapy (gait training)

Facility: Essentia Health Deer River

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $56
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Essentia Health Deer River is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 115 10Th Avenue Northeast, Deer River, MN.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $75 (258%)
Insurance Median: $56 (193%)
Cash: $75 (258% of Medicare)
Ins. Median: $56 (193% 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
Itasca Med Care $29 100%
Blue Cross Blue Shield $39 - $71 134%
Blue Plus Pmap Pcc Prime $39 - $56 134%
Healthpartners Care Pmap $41 141%
Advocare/Security Health $44 151%
Freedom Blue Ppo $44 151%
Healthpartners Care Msho / Mcr Adv $44 151%
Imcare Msho Pcc Prime $44 151%
Imcare Msho Ref Req $44 151%
Medica Advantage Solutions $44 151%
Medica Msho/Dual Solutions $44 151%
Medica Prime Solution Group $44 151%
Medicare (plans) $44 151%
Healthpartners $69 - $81 237%
America'S Ppo $79 272%
Cigna $80 - $81 275%
Healthpartners Pcc Prime $80 - $81 275%
Aetna $87 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 10Th Avenue Northeast, Deer River, MN 56636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals