Physical therapy (gait training)
Facility: University Medical Center
Billing Code: 97116 (CPT)
- CPT Billing Code: 97116
- Insurance Median: $110
- Cash Discount Price: $87
- vs. Medicare Baseline: 3.79x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aig | $19 - $163 | 65% |
| Cement Masons & Plasters H&W | $19 - $147 | 65% |
| Beech Street | $19 - $163 | 65% |
| Kaiser | $24 - $70 | 83% |
| Cigna | $24 - $70 | 83% |
| City of North Las Vegas | $24 - $147 | 83% |
| National Security Technologies | $24 - $70 | 83% |
| Cirque De Soleil | $24 - $70 | 83% |
| Great West Healthcare | $24 - $70 | 83% |
| Las Vegas Firefighters 1285 | $25 - $147 | 86% |
| UnitedHealthcare | $25 - $323 | 86% |
| Molina | $25 - $155 | 86% |
| American Postal Workers Health Plan | $25 - $323 | 86% |
| Blue Cross Blue Shield | $25 - $70 | 86% |
| Ambetter / Centene | $25 - $155 | 86% |
| Switch | $25 - $147 | 86% |
| Sierra Health and Life | $25 - $169 | 86% |
| Surest | $25 - $323 | 86% |
| So Ca Pipe Trades H&W | $33 - $70 | 114% |
| Southwest Carpenters H&W | $33 - $70 | 114% |
| Laborers Health and Welfare | $33 - $147 | 114% |
| Teamsters Local 986 | $33 - $147 | 114% |
| Teamsters Local 14 | $33 - $147 | 114% |
| Bricklayers Local 13 | $33 - $147 | 114% |
| California Ironwork Field Welfare | $33 - $70 | 114% |
| Ufcw Local 711 Retail Clerks | $33 - $147 | 114% |
| Operating Engineers | $33 - $147 | 114% |
| Teamsters Local 631 | $33 - $147 | 114% |
| Boyd Group | $33 - $147 | 114% |
| Electrical Workers | $33 - $147 | 114% |
| Caesar's Entertainment | $33 - $147 | 114% |
| Sheet Metal Workers | $33 - $70 | 114% |
| Plumbers & Pipefitters Loc 525 | $33 - $147 | 114% |
| Aetna | $45 - $127 | 155% |
| Nevada Energy | $49 | 169% |
| Coventry | $49 | 169% |
| Mail Handlers Benefit Plan | $49 | 169% |
| Health Net | $57 - $240 | 196% |
| First Health | $57 | 196% |
| Three Rivers Provider Network | $57 | 196% |
| Advantra Freedom | $70 | 241% |
| Clark County Detention Center | $85 | 292% |
| Alignment Health | $85 | 292% |
| Scan | $85 | 292% |
| Laughlin Coalition | $110 | 379% |
| Resorts World Las Vegas | $147 | 506% |
| Clark County EPO | $147 | 506% |
| Culinary Workers Hwf | $147 | 506% |
| Nevada Hand | $147 | 506% |
| Clark County Self Funded | $147 | 506% |
| Clark County Firefighters 1908 | $147 | 506% |
| City of Henderson | $147 | 506% |
| Mgm Grand | $147 | 506% |
| Mirage Las Vegas | $147 | 506% |
| Wynn Resorts | $147 | 506% |
| Las Vegas Metro Police Dept | $147 | 506% |
| Employee Painters Trust | $147 | 506% |
| Arroweye Solutions | $153 | 526% |
| Dignity Health | $153 | 526% |
| P3 Health Partners | $153 | 526% |
| Marshall Retail Group | $153 | 526% |
| Rebel Oil Company | $153 | 526% |
| Golden Entertainment | $153 | 526% |
| Stations Casinos | $153 | 526% |
| Teacher's Health Trust | $153 | 526% |
| Golden Nugget Hotel & Casino | $153 | 526% |
| Venetian/Palazzo | $153 | 526% |
| Pli Las Vegas | $153 | 526% |
| State of Nevada | $153 | 526% |
| Truline Corporation | $153 | 526% |
| Selecthealth | $155 | 533% |
| Health Direct Partners | $155 | 533% |
| Nevada Preferred Professionals | $169 | 582% |
| Zuffa | $169 | 582% |
| Universal Health Network (Uhn) | $169 | 582% |
| Prominence Health Plan | $169 | 582% |
| Jw Marriott | $169 | 582% |
| One Health Plan | $243 | 836% |
| Hometown Health Plan of Nevada | $243 | 836% |
| VA Pc3 (VA Choice) | $254 | 874% |
| Las Vegas Sand Corps | $323 | 1111% |