Physical therapy (gait training)
Facility: Intermountain Health Garfield Memorial Hospital
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $123
- Cash Discount Price: $97
- vs. Medicare Baseline: 4.23x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 423% of the Medicare baseline (a markup of 323%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $29 - $126 | 100% |
| Health Choice Utah | $29 - $116 | 100% |
| Healthy U | $29 - $116 | 100% |
| Medicare (plans) | $29 - $50 | 100% |
| Molina | $29 - $124 | 100% |
| Molina Healthcare Of Utah | $29 - $124 | 100% |
| Selecthealth | $29 - $124 | 100% |
| Triwest | $29 - $67 | 100% |
| Uofu | $29 - $124 | 100% |
| Tricare | $56 - $67 | 193% |
| UnitedHealthcare | $106 - $110 | 365% |
| Blue Cross Blue Shield | $123 - $124 | 423% |
| Byu Athletic Department | $123 - $124 | 423% |
| Campbell Scientific | $123 - $124 | 423% |
| Cigna | $123 - $124 | 423% |
| Deseret Mutual | $123 - $124 | 423% |
| Emi Health | $123 - $124 | 423% |
| Franklin County | $123 - $124 | 423% |
| Health Utah | $123 - $124 | 423% |
| Hygeia Corporation | $123 - $124 | 423% |
| Juniper Systems | $123 - $124 | 423% |
| Lw Miller | $123 - $124 | 423% |
| Managed Care Administrators, Inc. | $123 - $124 | 423% |
| Medcare International | $123 - $124 | 423% |
| Motivhealth | $123 - $124 | 423% |
| Pehp | $123 - $124 | 423% |
| Prodegi Corporate Benefit Services, Llc | $123 - $124 | 423% |
| Springtide | $123 - $124 | 423% |
| Tanner Llc | $123 - $124 | 423% |
| Utah State University | $123 - $124 | 423% |
| Utah Tech University | $123 - $124 | 423% |
| Wise | $123 - $124 | 423% |