CMS Price Transparency Data

Physical therapy (gait training)

Facility: Lee's Summit Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $40
  • Cash Discount Price: $243
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Lee's Summit Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.38x the Medicare baseline. Located in 2100 Se Blue Parkway, Lees Summit, MO.
Cash / Self-Pay
$243

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $243 (836%)
Insurance Median: $40 (138%)
Cash: $243 (836% of Medicare)
Ins. Median: $40 (138% 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
United $24 - $109 83%
Aetna $25 - $124 86%
Amerigroup $25 86%
Blue Cross Blue Shield $25 - $105 86%
Celtic $25 - $29 86%
Cigna $25 - $194 86%
Coventry $25 - $98 86%
Devoted Health $25 - $28 86%
Healthyblue $25 86%
Home State Health Plan $25 86%
Humana $25 - $61 86%
Medicaid / KanCare $25 86%
Unicare $25 86%
Wellcare $25 - $29 86%
Pyramid Life $27 - $30 93%
Multiplan $33 - $180 114%
Corvel Corporation $39 - $158 134%
Oha Network $40 - $122 138%
Ambetter / Centene $45 155%
Nhc Advantage $46 158%
Oscar $46 158%
Wppa Providrs Care Network $49 169%
Universal Healthcare $85 292%
Coventry Kc Mo $100 344%
College Park Family Care Center $105 361%
Focus Healthcare Mgmt, Inc $182 626%
Cco, Inc. $207 712%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2100 Se Blue Parkway, Lees Summit, MO 64063
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals