CMS Price Transparency Data

Physical therapy (gait training)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 97116 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$38
about 1.3× the $29 Medicare rate · typically $29–$66
modeled estimate · not a bill or quote
What this hospital charges insurers
$28
Below the fair price — a good deal
about $10 under the fair price · 1.0× Medicare
Medicare pays $29 Fair price $38 This hospital $28 Cash price $50 Hospital's list price $144

How we calculate the fair BaseRate →

How this hospital compares to other VA hospitals

One of the lower prices — 0 of 8 other VA hospitals charge more for the same procedure.

Cheapest $27 Priciest $28

Black dot = this hospital, among the 9 VA hospitals with a price for this procedure. Full list below.

A fair price for a Physical therapy (gait training) is about $38 (about 1.3× the $29 Medicare rate). Carilion Stonewall Jackson Hospital charges insurers about $28, or about $50 in cash — below the fair price — a good deal. Located in Lexington, VA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $28 - $118 96%
Blue Cross Blue Shieldmajor $26 89%
Aetnamajor $28 - $96 96%
Cignamajor $115 396%
Humanamajor $28 96%
Sentara $27 - $89 93%
+ 9 smaller / regional plans $79 - $137
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals