CMS Price Transparency Data

Physical therapy (gait training)

Facility: UPMC Carlisle

Billing Code: 97116 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$28
about 1.0× the $29 Medicare rate · typically $13–$56
modeled estimate · not a bill or quote
What this hospital charges insurers
$12
Below the fair price — a good deal
about $16 under the fair price · 0.4× Medicare
Medicare pays $29 Fair price $28 This hospital $12 Cash price $44 Hospital's list price $74

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $9 Priciest $12

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Physical therapy (gait training) is about $28 (about 1.0× the $29 Medicare rate). UPMC Carlisle charges insurers about $12, or about $44 in cash — below the fair price — a good deal. Located in Carlisle, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $11 - $148 38%
Blue Cross Blue Shieldmajor $11 - $40 38%
Aetnamajor $12 - $36 41%
Cignamajor $387 1332%
AmeriHealth $11 38%
Geisinger $12 - $53 41%
HealthPartners $11 38%
UPMC Health Plan $11 - $70 38%
+ 4 smaller / regional plans $10 - $59
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

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Facility Profile & Credentials

  • Address: 361 Alexander Spring Road, Carlisle, PA 17015
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals