CMS Price Transparency Data

Physical therapy (gait training)

Facility: Oklahoma Heart Hospital, LLC

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $38
  • Cash Discount Price: $24
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Oklahoma Heart Hospital, LLC is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $24. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.31x the Medicare baseline. Located in 4050 West Memorial Road, Oklahoma City, OK.
Cash / Self-Pay
$24

Average discount available for prompt cash payment at this facility.

Insurance Median
$38

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: $24 (83%)
Insurance Median: $38 (131%)
Cash: $24 (83% of Medicare)
Ins. Median: $38 (131% 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
Healthcare Highways $17 - $42 58%
Geha $22 76%
UnitedHealthcare $22 - $27 76%
Aetna $25 - $38 86%
Humana $25 - $48 86%
Blue Cross Blue Shield $27 - $52 93%
Cigna $27 - $40 93%
Medicare (plans) $27 - $28 93%
Va Ccn $27 93%
Veterans Eval Services $27 93%
Healthscope $32 110%
Oscar Insurance Company $32 110%
Webtpa Chickasaw Nation Hch $33 114%
Webtpa Hobby Lobby Hch $37 127%
Ambetter / Centene $38 131%
Coventry $41 141%
Global Health $44 151%
Sana Benefits $45 155%
Ufcw $45 155%
Community Care $48 - $54 165%
First Health Network $48 165%
Manhattan Life $48 165%
Phcs $48 165%
Preferred Community Choice $53 182%
Multiplan $62 213%
The Kempton Group $68 234%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4050 West Memorial Road, Oklahoma City, OK 73120
  • CMS Rating: ★★★★☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals