CMS Price Transparency Data

Physical therapy (gait training)

Facility: Colleton Medical Center

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $29
  • Cash Discount Price: $327
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Colleton Medical Center is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $327. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in 501 Robertson Boulevard, Walterboro, SC.
Cash / Self-Pay
$327

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $327 (1125%)
Insurance Median: $29 (100%)
Cash: $327 (1125% of Medicare)
Ins. Median: $29 (100% 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
Blue Choice $15 52%
United $15 - $180 52%
Absolute Total Care $24 - $61 83%
Aetna $24 - $196 83%
Arcadian $24 - $28 83%
Blue Cross Blue Shield $24 - $322 83%
Devoted Health $24 - $28 83%
Humana $24 - $305 83%
Molina $24 - $61 83%
Odyssey Hospice $24 - $28 83%
United Behavioral Health $24 - $28 83%
Wellcare $24 - $29 83%
Boldage Pace $25 - $29 86%
Clover $25 - $29 86%
Eon Health $25 - $29 86%
Cigna $26 - $219 89%
Align Networks $27 - $31 93%
Universal Healthcare Group $29 - $34 100%
Corvel Corporation $33 - $38 114%
Employer'S Health Network $33 - $38 114%
Prime Health $33 - $288 114%
Sc State Employees $34 - $52 117%
Heritage Summit $35 - $41 120%
Seven Corners $42 - $49 145%
Medical Development $50 - $59 172%
Naphcare $50 - $59 172%
Nhc Advantage $64 220%
Pruitt Health $64 220%
Blue Choice Health Plan $105 - $110 361%
Select Health $146 502%
Employers Health Network $153 526%
Value Option $170 585%
Vocational Rehab $183 630%
Medcost $191 - $247 657%
Mhnet $254 874%
Evernorth $271 933%
Multiplan $288 991%
North American Administrators $288 991%
First Health $305 1050%
Novanet $305 1050%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Robertson Boulevard, Walterboro, SC 29488
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals