CMS Price Transparency Data

Physical therapy (gait training)

Facility: Hillcrest Hospital Cushing

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $47
Cash Discount Price: $47
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Hillcrest Hospital Cushing is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.62x the Medicare baseline. Located in 1027 East Cherry Street, Cushing, OK.

Cash / Self-Pay

$47

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $47 (162%)

Insurance Median: $47 (162%)

Cash: $47 (162% of Medicare)

Ins. Median: $47 (162% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Black Lung [6055]	$39	134%
Healthcare Highways [2210]	$39 - $47	134%
Hooray Health [8000]	$39	134%
Lucent Health [6000]	$39	134%
Oncology Patient Assistance Programs [2295]	$39	134%
Oscar Insurance Company [7005]	$39	134%
Healthscope Benefits [2290]	$43	148%
UnitedHealthcare	$43 - $78	148%
Web Tpa [2115]	$47	162%
Cigna	$77	265%
Healthpartners [1500]	$77	265%
National Association Of Letter Carriers [1695]	$77	265%
Pba [1775]	$77	265%
Global Health [1430]	$97	334%
First Health [1375]	$109	375%
Multiplan [1680]	$109	375%
Healthcare Solutions [1485]	$111	382%
Healthsmart [1505]	$133	458%
Pending Ssi [1616]	$157	540%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $47.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Hillcrest Hospital Cushing is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.