CMS Price Transparency Data

Physical therapy (gait training)

Facility: Bmh-Golden Triangle

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $155
Cash Discount Price: $61
vs. Medicare Baseline: 5.33x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Bmh-Golden Triangle is $155. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $61. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.33x the Medicare baseline. Located in 2520 5Th Street N, Columbus, MS.

Cash / Self-Pay

$61

Average discount available for prompt cash payment at this facility.

Insurance Median

$155

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: $61 (210%)

Insurance Median: $155 (533%)

Cash: $61 (210% of Medicare)

Ins. Median: $155 (533% 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 533% of the Medicare baseline (a markup of 433%). 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 - $158	65%
Advanced Health Systems Inc.	$30	103%
Blue Cross Blue Shield	$30	103%
Magnolia Ms	$53 - $57	182%
Ppo Holdings	$89 - $96	306%
Magnolia Regional Health Center	$94 - $101	323%
Littler	$118 - $126	406%
Molina	$118 - $126	406%
Mpcn	$122 - $131	420%
Cigna	$129 - $139	444%
Primewell	$141 - $151	485%
Humana	$155 - $166	533%
UnitedHealthcare	$160 - $237	551%
First Choice Health Plan Of Ms	$164 - $176	564%
Multiplan	$176 - $189	606%
Novasys	$176 - $189	606%
Christian Health Aid	$188 - $202	647%
Ppo Plus	$200 - $214	688%
Qca	$212 - $227	730%

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 $61.
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 Bmh-Golden Triangle 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.