CMS Price Transparency Data

Physical therapy (gait training)

Facility: Bertrand Chaffee Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $28
  • Cash Discount Price: $58
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Bertrand Chaffee Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in 224 East Main Street, Springville, NY.
Cash / Self-Pay
$58

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $58 (200%)
Insurance Median: $28 (96%)
Cash: $58 (200% of Medicare)
Ins. Median: $28 (96% 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
Univera Essential Plans $25 86%
Univera Hc Child Health+ $25 86%
Univera Hc Myhealth+ $25 86%
Univera Plus Med $25 86%
Advantra-Mcr Advantage $28 96%
Aetna $28 - $68 96%
Blue Cross Blue Shield $28 - $49 96%
Centers Plan Hlty Living $28 96%
Champva $28 96%
Cigna $28 - $68 96%
Ctrs Plan For Hlthy Livng $28 96%
Geisinger Health Plan $28 96%
Humana $28 96%
Lifetime Benefits $28 96%
Medicare (plans) $28 96%
Mutual Of Omaha $28 96%
Optimum Healthcare - Mcr $28 96%
Senior Blue - Bc $28 96%
Todays Option - Amer Prog $28 96%
Tricare $28 96%
United Hc Mcr Solutions $28 96%
UnitedHealthcare $28 96%
Wellcare $28 96%
Univera Senior Choice $29 100%
Univera Healthcare $32 110%
Private Pay $58 200%
American Progressive Ins. $68 234%
Commercial / Misc $68 234%
Global Excel Mgt $68 234%
Guardian Life Ins. Co. $68 234%
Mvp Commercial $68 234%
No Amer Meritian Health $68 234%
No-Fault $68 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 224 East Main Street, Springville, NY 14141
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals