CMS Price Transparency Data

Physical therapy (gait training)

Facility: Henrico Doctors' Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $358
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Henrico Doctors' Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 1602 Skipwith Road, Richmond, VA.
Cash / Self-Pay
$358

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: $358 (1232%)
Insurance Median: $31 (107%)
Cash: $358 (1232% 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
Triatlantic $24 83%
Aetna $26 - $30 89%
Devoted $26 - $30 89%
Health Net $26 89%
Humana $26 - $30 89%
Sentara Health $26 - $30 89%
United $26 - $166 89%
United Behavioral Health $26 - $30 89%
UnitedHealthcare $26 - $30 89%
Virginia Premier Health $26 - $30 89%
Cigna $27 - $31 93%
Clear Spring Health Plan $27 - $31 93%
Davita Village Health $27 - $31 93%
Evernorth Behavioral Health $27 - $31 93%
Align Senior Care $28 - $32 96%
Pyramid Life $28 - $32 96%
Johns Hopkins $29 100%
Bright Health $56 - $59 193%
Oscar $59 - $63 203%
Lifeworks $66 - $70 227%
Universal Healthcare Group $76 - $81 262%
Virginia Health Network $121 - $239 416%
Greenvbrier Sporting Club $208 - $221 716%
Corvel $250 - $265 860%
Occunet Workers Comp $278 - $294 957%
4Most Health Nework $312 - $331 1074%
Multiplan $312 - $331 1074%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1602 Skipwith Road, Richmond, VA 23229
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals