CMS Price Transparency Data

Physical therapy (gait training)

Facility: Memorial Hospital at Gulfport

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $169
Cash Discount Price: $409
vs. Medicare Baseline: 5.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Memorial Hospital at Gulfport is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $409. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.82x the Medicare baseline. Located in 4500 13Th Street, Gulfport, MS.

Cash / Self-Pay

$409

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $409 (1407%)

Insurance Median: $169 (582%)

Cash: $409 (1407% of Medicare)

Ins. Median: $169 (582% 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 582% of the Medicare baseline (a markup of 482%). 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
UnitedHealthcare	$24 - $265	83%
Magnolia Health	$25 - $56	86%
Molina	$25 - $59	86%
Blue Cross Blue Shield	$30 - $39	103%
Humana	$39 - $421	134%
Sas Mhg	$88 - $356	303%
Primewell	$89	306%
Cigna	$105 - $351	361%
Fox Everett	$234	805%
Sas Non-Mhg	$234	805%
Aetna	$292	1005%
First Choice	$292 - $421	1005%
Mhg	$292	1005%
First Health	$421	1449%
Mpcn	$438	1507%

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 $409.
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 Memorial Hospital at Gulfport 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.