CMS Price Transparency Data

Physical therapy (gait training)

Facility: Prosser Memorial Hospital

Billing Code: 97116 (CPT)

The BaseRate · fair price low confidence
A fair price for this
$71
about 2.4× the $29 Medicare rate · typically $16–$135
modeled estimate · not a bill or quote
What this hospital charges insurers
$135
Well above the fair price
about $64 over the fair price · 4.7× Medicare
Medicare pays $29 Fair price $71 This hospital $135 Cash price $87 Hospital's list price $159

How we calculate the fair BaseRate →

How this hospital compares to other WA hospitals

Highest price of the 9 WA hospitals we have prices for — worth calling around.

Cheapest $18 Priciest $135

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

A fair price for a Physical therapy (gait training) is about $71 (about 2.4× the $29 Medicare rate). Prosser Memorial Hospital charges insurers about $135, or about $87 in cash — well above the fair price. Located in Prosser, WA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $71. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

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

6 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 $34 - $135 117%
Blue Cross Blue Shieldmajor $127 - $143 437%
Aetnamajor $48 - $135 165%
Cignamajor $130 447%
Humanamajor $40 - $135 138%
Kaiser Permanentemajor $32 - $145 110%
Ambetter (Centene) $111 - $122 382%
Amerigroup $36 - $68 124%
Molina $36 - $64 124%
WellCare $40 138%
+ 6 smaller / regional plans $34 - $143
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 723 Memorial Street, Prosser, WA 99350
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals