CMS Price Transparency Data

Physical therapy (gait training)

Facility: Temple Health - Chestnut Hill Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $173
Cash Discount Price: Unavailable
vs. Medicare Baseline: 5.95x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at Temple Health - Chestnut Hill Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.95x the Medicare baseline. Located in 8835 Germantown Avenue, Philadelphia, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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%)

Insurance Median: $173 (595%)

Ins. Median: $173 (595% 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 595% of the Medicare baseline (a markup of 495%). 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
Gateway Health Plan	$8	28%
Geisinger	$10 - $574	34%
Health Partners Plans	$10	34%
Pennsylvania Health And Wellness	$10 - $271	34%
UnitedHealthcare	$11 - $436	38%
Upmc Health Plan	$12 - $17	41%
Blue Cross Blue Shield	$30 - $179	103%
Cigna	$131 - $348	451%
Innovage	$138 - $174	475%
Aetna	$151 - $634	520%
Keystone First	$171 - $216	588%
Point Comfort	$222 - $279	764%
Occunet	$250	860%
Devon Health	$543 - $683	1869%

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 $X.
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 Temple Health - Chestnut Hill 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.