CMS Price Transparency Data

Physical therapy (gait training)

Facility: Excela Health Latrobe Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $28
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Excela Health Latrobe Hospital is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in One Mellon Way, Latrobe, PA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $46 (158%)
Insurance Median: $28 (96%)
Cash: $46 (158% of Medicare)
Ins. Median: $28 (96% 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
Highmark Advantage Community Blue $10 - $26 34%
Health Partners Plan $11 - $29 38%
Martin'S Point $11 - $29 38%
Peak Health $11 - $65 38%
Va $11 - $28 38%
American Health Plan Of Pa $12 - $31 41%
Amerihealth Caritas $12 - $29 41%
Cigna $12 - $69 41%
Devoted $12 - $29 41%
Geisinger $12 - $29 41%
Highmark Wholecare $12 - $30 41%
Humana $12 - $29 41%
Pa Health And Wellness $12 - $30 41%
Provider Network Of America $12 - $61 41%
Provider Plan Partners Plan $12 - $31 41%
The Health Plan Of West Virginia $12 - $65 41%
United $12 - $29 41%
UnitedHealthcare $12 - $31 41%
Upmc $12 - $30 41%
Upmc For Kids Chip $12 41%
Highmark Children'S Health Insurance Program $13 - $33 45%
Upmc Health Plan $13 - $55 45%
Ambetter / Centene $14 - $35 48%
Highmark $15 - $61 52%
Velocity $17 - $42 58%
Community Blue $22 - $55 76%
Aetna $29 - $64 100%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Mellon Way, Latrobe, PA 15650
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals