CMS Price Transparency Data

Physical therapy (gait training)

Facility: Curry General Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $133
Cash Discount Price: $140
vs. Medicare Baseline: 4.58x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Curry General Hospital is $133. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.58x the Medicare baseline. Located in 94220 Fourth Street, Gold Beach, OR.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$133

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: $140 (482%)

Insurance Median: $133 (458%)

Cash: $140 (482% of Medicare)

Ins. Median: $133 (458% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 458% of the Medicare baseline (a markup of 358%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Partnership Health Plan Of Calif Mdcd Hmo [2008]	$19	65%
Tricare	$44	151%
Covid19 Hrsa Uninsured Testing And Treatment Fund [2271]	$61	210%
Medicare (plans)	$61 - $91	210%
Blue Cross Blue Shield	$71 - $140	244%
First Choice Health Admin [1294]	$87	299%
First Choice [528]	$87	299%
Medicaid / KanCare	$88 - $91	303%
Department Of Corrections [1051]	$91	313%
Coordinated Care Commercial [1649]	$119	409%
Pacificsource [1148]	$119	409%
Moda [512]	$120 - $126	413%
Multiplan [1131]	$127	437%
Asuris [1258]	$133	458%
Operating Engineers [1144]	$133	458%
Regence [1351]	$133 - $140	458%
Cigna	$137 - $140	471%
Coventry First Health Managed Care [1774]	$137	471%
Coventry Health [1046]	$137	471%
Providence Health Plan Plm Alt [1692]	$137	471%
Providence Health Plan [567]	$137	471%
Aetna	$140	482%
Employee Bene Admin Mgmt [525]	$140	482%
Geha [531]	$140	482%
Mailhandlers Benefit Pln [547]	$140	482%
Meritain [550]	$140	482%
Nw Sheet Metal Workers [597]	$140	482%
Trustmark [524]	$140	482%
UnitedHealthcare	$140	482%
Zenith Administrators [586]	$140	482%
Allcare Alt [2598]	$300	1032%
Allcare [1695]	$300	1032%

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 $140.
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 Curry General Hospital 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.