CMS Price Transparency Data

Physical therapy (gait training)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $39
  • Cash Discount Price: $57
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Ohiohealth Morrow County Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.34x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.
Cash / Self-Pay
$57

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $57 (196%)
Insurance Median: $39 (134%)
Cash: $57 (196% of Medicare)
Ins. Median: $39 (134% 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
Aetna $33 - $76 114%
Blue Cross Blue Shield $33 - $68 114%
Humana $33 - $82 114%
Medicare (plans) $33 114%
UnitedHealthcare $33 - $72 114%
Medicaid / KanCare $38 - $39 131%
Amerihealth Caritas - All Plans $39 134%
Caresource Marketplace - All Other Plans $41 141%
Molina Exchange - All Other Plans $63 217%
Medical Mutual Of Ohio Marketplace $66 227%
Ohiohealthy Network - All Other Plans $66 227%
Ohiohealthy Preferred $66 227%
Medical Mutual Of Ohio Comm - All Other Plans $71 244%
Medical Mutual Of Ohio - Admin Serv $75 258%
Phcs - All Plans $81 279%
Cigna $83 286%
Multiplan - All Plans $84 289%
Healthstar Comm - All Plans $85 292%
Beech Street - All Plans $86 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 West Marion Road, Mount Gilead, OH 43338
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals