CMS Price Transparency Data

Physical therapy (gait training)

Facility: Baptist Memorial Hospital Booneville

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $121
Cash Discount Price: $47
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Baptist Memorial Hospital Booneville is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.16x the Medicare baseline. Located in 100 Hospital Street, Booneville, MS.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $47 (162%)

Insurance Median: $121 (416%)

Cash: $47 (162% of Medicare)

Ins. Median: $121 (416% 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 416% of the Medicare baseline (a markup of 316%). 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
Aetna	$19 - $139	65%
Advanced Health Systems Inc.	$30	103%
Blue Cross Blue Shield	$30	103%
Magnolia Ms	$39 - $50	134%
Ppo Holdings	$66 - $84	227%
Magnolia Regional Health Center	$69 - $89	237%
Littler	$86 - $111	296%
Molina	$86 - $111	296%
Mpcn	$90 - $115	310%
Cigna	$95 - $122	327%
Primewell	$104 - $133	358%
UnitedHealthcare	$104 - $147	358%
Humana	$114 - $147	392%
First Choice Health Plan Of Ms	$121 - $155	416%
Multiplan	$130 - $166	447%
Novasys	$130 - $166	447%
Christian Health Aid	$138 - $178	475%
Ppo Plus	$147 - $189	506%
Qca	$156 - $200	537%

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 $47.
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 Baptist Memorial Hospital Booneville 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.