CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Houston Healthcare Clear Lake

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $33
  • Cash Discount Price: $259
  • vs. Medicare Baseline: 1.14x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Houston Healthcare Clear Lake is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.14x the Medicare baseline. Located in 500 W Medical Center Blvd, Webster, TX.
Cash / Self-Pay
$259

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $259 (891%)
Insurance Median: $33 (114%)
Cash: $259 (891% of Medicare)
Ins. Median: $33 (114% 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
Superior Health Plan $14 - $31 48%
Oscar $25 - $56 86%
Aetna $26 - $157 89%
Amerigroup $26 - $40 89%
Blue Cross Blue Shield $26 - $100 89%
Chc Harris Health $26 - $29 89%
Cigna $26 - $229 89%
Devoted Health $26 - $29 89%
Humana $26 - $292 89%
Integranet Amerigroup Ipa $26 - $30 89%
Kelsey Seybold $26 - $29 89%
Renaissance Ipa Radiology $26 - $29 89%
Triwest Healthcare Alliance $26 - $29 89%
United $26 - $129 89%
Van Lang Ipa $26 - $30 89%
Wellcare $26 - $30 89%
Wellmed $26 - $29 89%
American Health Plan $27 - $31 93%
Procare Advantage $27 - $31 93%
Provider Partners Health Plan Of Texas $27 - $31 93%
Shared Health $27 - $31 93%
Molina $28 - $32 96%
Christus (Usfhp) $29 100%
Triwest Health Alliance $29 100%
Community Health Choice Mcd $30 - $37 103%
Kindred Hospital $30 - $34 103%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Community Health Choice $37 - $42 127%
Superior $37 - $45 127%
Texas Childrens Health Plans $39 - $68 134%
Utmb $42 - $48 145%
Corvel Corporation $51 - $58 175%
Omni Healthcare $54 - $61 186%
Molina Healthcare $55 - $63 189%
Texas Workforce Commission $56 - $69 193%
Healthsmart Preferred Care $100 - $243 344%
Fidelis Securecare Of Tx $105 - $129 361%
Multiplan $116 - $257 399%
Coventry National First Health $124 - $152 427%
Physicians Cooperative Of Texas $128 - $157 440%
Rockport Workers Comp $128 - $157 440%
Beech Street $140 - $229 482%
Independent Medical System $140 - $172 482%
National Healthcare Solutions $140 - $172 482%
Southwest Medical $140 - $172 482%
Coastal Comp $151 - $186 520%
Physicians, Inc $198 - $243 681%
Affiliated Ppo $209 - $257 719%
Texas Athletic Network $300 - $600 1032%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 500 W Medical Center Blvd, Webster, TX 77598
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals