CMS Price Transparency Data

Physical therapy (gait training)

Facility: Lewisgale Hospital Alleghany

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $29
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at Lewisgale Hospital Alleghany is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $338 (1163%)
Insurance Median: $29 (100%)
Cash: $338 (1163% of Medicare)
Ins. Median: $29 (100% 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 $25 - $183 86%
Devoted $25 - $29 86%
Good Samaritan Hospice $25 - $29 86%
Humana $25 - $29 86%
Sentara Health $25 - $29 86%
United $25 - $152 86%
United Behavioral Health $25 - $29 86%
United Mine Workers $25 - $29 86%
Blue Cross Blue Shield $26 - $30 89%
Cigna $26 - $30 89%
Health Net $26 89%
Virginia Premier Health $26 - $29 89%
Align Senior Care $27 - $31 93%
Clear Spring Health Plan $27 - $30 93%
Lifeworks $64 220%
Universal Healthcare Group $74 255%
Virginia Health Network $118 - $240 406%
Greenbrier Sporting Club $123 423%
Greenvbrier Sporting Club $203 699%
Corvel $243 836%
Csx Hotels $270 929%
Occunet Workers Comp $270 929%
Health Payors Organization $287 988%
4Most $304 1046%
Alleghany Highland Community $304 1046%
American Postal Workers Union $304 1046%
C&O Employees Hospital Assn $304 1046%
Community Care Network $304 1046%
Multiplan $304 1046%
One Health Plan $304 1046%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Arh Lane - Po Box 7, Low Moor, VA 24457
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals