CMS Price Transparency Data

Physical therapy (gait training)

Facility: Angel Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Angel Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 124 Center Court Po Box 1209, Franklin, NC.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $84 (289%)
Insurance Median: $32 (110%)
Cash: $84 (289% of Medicare)
Ins. Median: $32 (110% 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
Blue Cross Blue Shield $14 - $15 48%
United $15 - $38 52%
Amerihealth $16 55%
Partners Health Management $16 55%
Vaya Health $16 55%
Wellcare $16 55%
Apex Health $17 58%
Aetna $18 - $54 62%
Amerigroup $19 65%
Cigna $29 - $48 100%
One Call Medical $30 - $34 103%
Amerihealth Caritas $33 114%
Caresource $37 127%
Medcost $37 - $44 127%
Magellan $50 172%
Magellan Behavioral Health $50 172%
Multiplan $67 231%
Avalon Administrative Services $71 244%
Prime Health $74 - $76 255%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 124 Center Court Po Box 1209, Franklin, NC 28734
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals