CMS Price Transparency Data

Physical therapy (gait training)

Facility: Tennova Healthcare - Clarksville

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $40
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Tennova Healthcare - Clarksville is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.38x the Medicare baseline. Located in 651 Dunlop Lane, Clarksville, TN.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $73 (251%)
Insurance Median: $40 (138%)
Cash: $73 (251% of Medicare)
Ins. Median: $40 (138% 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 Cross Blue Shield $17 - $95 58%
Amerigroup $25 86%
Tricare $26 89%
American Health $27 93%
Humana $27 - $83 93%
Medicare (plans) $27 93%
Node Ascension Complete Mcr Adv $27 93%
Node Bluecare Plus Tn Mcr Adv $27 93%
Node Champva $27 93%
Node Devoted Health Mcr Adv $27 93%
Node Farm Bureau Mcr Adv $27 93%
Node Healthspring Mcr Adv $27 93%
Node Hospice Non Par Agree $27 93%
Node Va $27 93%
Node Wellcare Mcr Adv $27 93%
Node Windsor Mcr Dual $27 93%
UnitedHealthcare $27 - $271 93%
Veterans Eval Services $27 93%
Aetna $28 - $85 96%
Node Amerigroup Mcr Adv $28 96%
Node Nhc Mcr Adv $29 100%
Cigna $35 - $116 120%
Corvel $39 134%
Rockport Work Comp Tn $39 134%
Novanet Work Comp Tn $40 138%
Prime Health Work Comp Tn $40 138%
Tn Work Comp $41 141%
Node Us Dept Of Labor $43 148%
Ambetter / Centene $50 172%
Node Valenz Access $54 186%
Naphcare $61 210%
Ky Work Comp $71 244%
Self Pay $73 251%
Medicaid / KanCare $74 - $94 255%
Wellcare $94 323%
Oscar $150 516%
Center Care $245 843%
Correct Care Solutions $339 1167%
First Health $339 1167%
Multiplan $358 1232%
Phcs $358 1232%
Prime Health Services $358 1232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 Dunlop Lane, Clarksville, TN 37040
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals