CMS Price Transparency Data

Physical therapy (gait training)

Facility: Ochsner Medical Center-Hancock

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $29
  • Cash Discount Price: $45
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Ochsner Medical Center-Hancock is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in 149 Drinkwater Blvd, Bay Saint Louis, MS.
Cash / Self-Pay
$45

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $45 (155%)
Insurance Median: $29 (100%)
Cash: $45 (155% of Medicare)
Ins. Median: $29 (100% 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
Humana $20 - $27 69%
Medicaid / KanCare $24 - $25 83%
Aetna $27 - $96 93%
Cigna $27 - $162 93%
Magnolia Health Plan – Wellcare By All Well Of Mississippi $27 93%
Medicare (plans) $27 - $28 93%
UnitedHealthcare $27 - $235 93%
Shared Health Mississippi $28 96%
Blue Cross Blue Shield $30 - $33 103%
Ambetter / Centene $43 148%
Mississippi Physicians Care Network $60 206%
Zelis $62 213%
Primewell Health Services Commercial Exchange Plan $75 258%
Primewell Health Services – Commercial $75 258%
Claritev D/B/A Multiplan/Phcs/American Life Care $76 262%
Healthcomp & Personify Health (Formerly Gilsbar) $83 286%
Select Administrative Services Network $83 286%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 149 Drinkwater Blvd, Bay Saint Louis, MS 39520
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals