CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: North Alabama Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $25
Cash Discount Price: $96
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at North Alabama Medical Center is $25. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.86x the Medicare baseline. Located in 1701 Veterans Drive, Florence, AL.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$25

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: $96 (330%)

Insurance Median: $25 (86%)

Cash: $96 (330% of Medicare)

Ins. Median: $25 (86% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Wellpoint Tennessee, Inc.	$20	69%
Healthspring Markets	$21	72%
Aetna	$22 - $23	76%
Humana	$22	76%
UnitedHealthcare	$23 - $63	79%
Ambetter / Centene	$25	86%
Blue Cross Blue Shield	$30	103%
Viva Health	$34	117%
Cigna	$110 - $130	379%
Paradigm	$126	434%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $96.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm North Alabama Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.