CMS Price Transparency Data

Physical therapy (gait training)

Facility: Womans Hospital of Texas,The

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $241
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Womans Hospital of Texas,The is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $241. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 7600 Fannin, Houston, TX.
Cash / Self-Pay
$241

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $241 (829%)
Insurance Median: $31 (107%)
Cash: $241 (829% of Medicare)
Ins. Median: $31 (107% 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 $13 - $31 45%
Oscar $25 - $51 86%
Amerigroup $26 - $37 89%
Blue Cross Blue Shield $26 - $121 89%
Cigna $26 - $29 89%
Devoted Health $26 - $29 89%
Humana $26 - $292 89%
Integranet Amerigroup Ipa $26 - $30 89%
Kelsey Seybold $26 - $30 89%
Triwest Healthcare Alliance $26 - $29 89%
United $26 - $118 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%
Community Health Choice Mcd $28 - $34 96%
Molina $28 - $32 96%
Christus (Usfhp) $29 100%
Triwest Health Alliance $29 100%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Community Health Choice $37 - $42 127%
Superior $37 - $45 127%
Corvel Corporation $51 - $58 175%
Texas Childrens Health Plans $52 - $69 179%
Omni Healthcare $54 - $61 186%
Molina Healthcare $56 - $64 193%
Aetna $91 - $182 313%
Healthsmart Preferred Care $94 - $223 323%
Fidelis Securecare Of Tx $99 - $118 341%
Coventry National First Health $117 - $140 403%
Physicians Cooperative Of Texas $121 - $144 416%
Rockport Workers Comp $121 - $144 416%
Independent Medical System $132 - $158 454%
National Healthcare Solutions $132 - $158 454%
Southwest Medical $132 - $158 454%
Coastal Comp $143 - $171 492%
Affiliated Ppo $164 - $197 564%
Fiesta Mart, Inc $164 - $197 564%
Multiplan $164 - $223 564%
Physicians, Inc $186 - $223 640%
Texas Athletic Network $300 - $600 1032%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7600 Fannin, Houston, TX 77054
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals