CMS Price Transparency Data

Physical therapy (gait training)

Facility: Door County Medical Center

Billing Code: 97116 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$65
about 2.2× the $29 Medicare rate · typically $30–$135
modeled estimate · not a bill or quote
What this hospital charges insurers
$54
Below the fair price — a good deal
about $11 under the fair price · 1.9× Medicare
Medicare pays $29 Fair price $65 This hospital $54 Cash price $125 Hospital's list price $166

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

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

Cheapest $25 Priciest $54

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

A fair price for a Physical therapy (gait training) is about $65 (about 2.2× the $29 Medicare rate). Door County Medical Center charges insurers about $54, or about $125 in cash — below the fair price — a good deal. Located in Sturgeon Bay, WI.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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 $54 - $127 186%
Blue Cross Blue Shieldmajor $54 - $140 186%
Aetnamajor $54 - $56 186%
Humanamajor $53 - $54 182%
HealthPartners $53 182%
+ 2 smaller / regional plans $65 - $99
Government programs also on file: Medicare.

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Facility Profile & Credentials

  • Address: 323 South 18Th Avenue, Sturgeon Bay, WI 54235
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals