CMS Price Transparency Data

Physical therapy (gait training)

Facility: Greeneville Community Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $39
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Greeneville Community Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.34x the Medicare baseline. Located in 1420 Tusculum Boulevard, Greeneville, TN.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $27 (93%)
Insurance Median: $39 (134%)
Cash: $27 (93% of Medicare)
Ins. Median: $39 (134% 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 $15 - $116 52%
Amerigroup $26 - $29 89%
Aetna $28 - $78 96%
Humana $28 96%
Managed Medicaire $28 96%
Medicare (plans) $28 96%
Sentara Health $28 - $47 96%
United Mine Workers Of America $28 96%
UnitedHealthcare $28 - $183 96%
Cigna $29 - $85 100%
Devoted Health Plan $29 100%
Mountain Empire Pace $29 100%
Nhc Advantage $29 100%
Wellcare $29 - $183 100%
Optima Health $39 134%
Ambetter / Centene $60 206%
Medcost $87 299%
First Health Coventry $146 502%
Molina Healthcare $183 630%
Seven Corners, Inc. $183 630%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1420 Tusculum Boulevard, Greeneville, TN 37745
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals