CMS Price Transparency Data

Physical therapy (gait training)

Facility: Parkland Health Center - Bonne Terre

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $111
Cash Discount Price: $90
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Parkland Health Center - Bonne Terre is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.82x the Medicare baseline. Located in 7245 Raider Road, Bonne Terre, MO.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $90 (310%)

Insurance Median: $111 (382%)

Cash: $90 (310% of Medicare)

Ins. Median: $111 (382% 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 382% of the Medicare baseline (a markup of 282%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medica [662]	$29	100%
Aetna	$68 - $112	234%
Healthlink [225]	$73 - $113	251%
Cox Health Systems Insurance Company [220]	$82 - $98	282%
Health Alliance [224]	$82	282%
Allied Benefits [498]	$87 - $111	299%
Hope Trust [806]	$87	299%
Coresource [497]	$90	310%
Fmh Benefit Service Inc [222]	$90	310%
Mail Handlers [495]	$90	310%
Cigna	$93 - $120	320%
Healthscope Benefits [258]	$98 - $101	337%
Med-Pay [480]	$98 - $112	337%
Unicare [568]	$98 - $113	337%
Humana	$100	344%
UnitedHealthcare	$101 - $111	348%
Apwu Health Plan [216]	$105	361%
Nalc Health Benefit Plan [242]	$105	361%
Priority Health [648]	$105	361%
First Health Commercial [734]	$111	382%
Beechstreet [551]	$112	385%
Detego Health [868]	$112	385%
Health Systems Inc [620]	$112	385%
Healthcare Sol Mercy [609]	$112	385%
Multiplan Commercial [737]	$112	385%
Multiplan [240]	$112	385%
Phcs [244]	$112 - $120	385%
Preferred Health Professionals [561]	$113	389%
Hfn [563]	$120	413%
Medica [661]	$120	413%
Blue Cross Blue Shield	$128 - $211	440%
Consociate [478]	$227	781%
Sarah Bush Lincoln [636]	$227	781%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $90.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Parkland Health Center - Bonne Terre is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.