CMS Price Transparency Data
Physical therapy (gait training)
Facility: St John's Episcopal Hospital at South Shore
Billing Code: 97116 (CPT)
The BaseRate · fair price medium confidence
A fair price for this
$46
about 1.6× the $29 Medicare rate · typically $29–$127
modeled estimate · not a bill or quote
Medicare pays $29 Fair price $46 Cash price $11 Hospital's list price $11
What each insurance company pays
Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.
4 of 6 major insurers have a published price at this hospital
✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente
Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.
| Insurance company | Price range | vs. Medicare |
|---|---|---|
| UnitedHealthcaremajor | $33 | 114% |
| Blue Cross Blue Shieldmajor | $33 - $49 | 114% |
| Aetnamajor | $33 - $46 | 114% |
| Humanamajor | $33 | 114% |
| Fidelis Care | $33 | 114% |
| MagnaCare | $174 | 599% |
| Molina | $36 | 124% |
| WellCare | $33 | 114% |
| + 10 smaller / regional plans | $27 - $73 |
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Other Procedures at St John's Episcopal Hospital at South Shore
Compare: Physical therapy (gait training) at other NY hospitals
- Crouse Hospital · Syracuse $27
- Geneva General Hospital · Geneva $28
- F F Thompson Hospital · Canandaigua $28
- Arnot Ogden Medical Center · Elmira $28
- Jones Memorial Hospital · Wellsville $28
- Bertrand Chaffee Hospital · Springville $28
- Oswego Hospital · Oswego $28
- Nicholas H Noyes Memorial Hospital · Dansville $28
Insurance negotiated median for the same procedure, sorted lowest first.