CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Houston Healthcare Kingwood

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $199
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Houston Healthcare Kingwood is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $199. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 22999 Us Hwy 59, Kingwood, TX.
Cash / Self-Pay
$199

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: $199 (685%)
Insurance Median: $31 (107%)
Cash: $199 (685% 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 $11 - $31 38%
Community Health Choice Mcd $25 - $27 86%
Oscar $25 - $41 86%
Aetna $26 - $157 89%
Amerigroup $26 - $29 89%
Blue Cross Blue Shield $26 - $100 89%
Chc Harris Health $26 - $29 89%
Cigna $26 - $29 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 - $94 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%
Universal Healthcare Group $31 - $35 107%
Texas Childrens Health Plans $32 - $49 110%
Verda Health Plan $33 - $38 114%
Community Health Choice $37 - $42 127%
Superior $37 - $45 127%
Usa Managed Care $49 - $177 169%
Corvel Corporation $51 - $58 175%
Omni Healthcare $54 - $61 186%
Molina Healthcare $55 - $63 189%
Healthsmart Preferred Care $82 - $177 282%
Fidelis Securecare Of Tx $86 - $94 296%
Coventry National First Health $102 - $111 351%
Physicians Cooperative Of Texas $105 - $114 361%
Rockport Workers Comp $105 - $114 361%
Independent Medical System $115 - $125 396%
National Healthcare Solutions $115 - $125 396%
Southwest Medical $115 - $125 396%
Coastal Comp $124 - $135 427%
Multiplan $143 - $177 492%
Physicians, Inc $162 - $177 557%
Affiliated Ppo $172 - $187 592%
Texas Athletic Network $300 - $600 1032%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 22999 Us Hwy 59, Kingwood, TX 77325
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals