CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Houston Healthcare Conroe

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $36
  • Cash Discount Price: $448
  • vs. Medicare Baseline: 1.24x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Houston Healthcare Conroe is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $448. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.24x the Medicare baseline. Located in 504 Medical Center Blvd, Conroe, TX.
Cash / Self-Pay
$448

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $448 (1542%)
Insurance Median: $36 (124%)
Cash: $448 (1542% of Medicare)
Ins. Median: $36 (124% 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
Oscar $24 - $91 83%
Aetna $25 - $157 86%
Amerigroup $25 - $65 86%
Blue Cross Blue Shield $25 - $163 86%
Cigna $25 - $28 86%
Devoted Health $25 - $28 86%
Geo Group - Joe Corley Detention Facility $25 - $28 86%
Humana $25 - $292 86%
Kelsey Seybold $25 - $28 86%
Triwest Healthcare Alliance $25 - $28 86%
United $25 - $209 86%
Van Lang Ipa $25 - $29 86%
Wellmed $25 - $28 86%
American Health Plan $26 - $30 89%
Integranet Amerigroup Ipa $26 - $29 89%
Procare Advantage $26 - $30 89%
Provider Partners Health Plan Of Texas $26 - $30 89%
Shared Health $26 - $30 89%
Superior Health Plan $26 - $30 89%
Wellcare $26 - $29 89%
Molina $27 - $31 93%
Christus (Usfhp) $28 96%
Universal Healthcare Group $30 - $34 103%
Verda Health Plan $32 - $37 110%
Community Health Choice $36 - $41 124%
Superior $36 - $44 124%
Corvel Corporation $49 - $56 169%
Omni Healthcare $52 - $59 179%
Molina Healthcare $54 - $61 186%
Community Health Choice Mcd $56 - $60 193%
Texas Childrens Health Plans $88 - $110 303%
Tx Workforce Commission $103 - $112 354%
Healthsmart Preferred Care $185 - $395 637%
Fidelis Securecare Of Tx $194 - $209 668%
Coventry National First Health $230 - $248 791%
Physicians Cooperative Of Texas $237 - $256 816%
Rockport Workers Comp $237 - $256 816%
Independent Medical System $258 - $279 888%
National Healthcare Solutions $258 - $279 888%
Southwest Medical $258 - $279 888%
Coastal Comp $280 - $302 964%
Texas Athletic Network $300 - $600 1032%
Multiplan $323 - $395 1111%
Physicians, Inc $366 - $395 1259%
Affiliated Ppo $388 - $419 1335%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 504 Medical Center Blvd, Conroe, TX 77304
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals