CMS Price Transparency Data

Physical therapy (gait training)

Facility: UPMC Presbyterian Shadyside

Billing Code: 97116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$28
about 1.0× the $29 Medicare rate · typically $23–$40
modeled estimate · not a bill or quote
What this hospital charges insurers
$26
About the fair price
about $2 under the fair price · 0.9× Medicare
Medicare pays $29 Fair price $28 This hospital $26 Cash price $198 Hospital's list price $330

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 $26

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 Presbyterian Shadyside charges insurers about $26, or about $198 in cash — about the fair price. Located in Pittsburgh, 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✓ Humana CignaKaiser 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 $10 34%
Blue Cross Blue Shieldmajor $12 - $165 41%
Aetnamajor $11 - $82 38%
Humanamajor $280 964%
AmeriHealth $13 45%
Fidelis Care $248 853%
Geisinger $13 45%
HealthPartners $13 45%
UPMC Health Plan $9 - $112 31%
+ 6 smaller / regional plans $14 - $280
Excludes 3 rental-network / third-party entries (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: 200 Lothrop Street, Pittsburgh, PA 15213
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals