CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Grandview Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $185
  • Cash Discount Price: $89
  • vs. Medicare Baseline: 6.37x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Grandview Medical Center is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 6.37x the Medicare baseline. Located in 3690 Grandview Parkway, Birmingham, AL.
Cash / Self-Pay
$89

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $89 (306%)
Insurance Median: $185 (637%)
Cash: $89 (306% of Medicare)
Ins. Median: $185 (637% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 637% of the Medicare baseline (a markup of 537%). 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.

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
Medicaid / KanCare $22 76%
Tricare $25 86%
Blue Advantage $27 93%
Cigna $27 - $171 93%
Hospice $27 93%
Humana $27 93%
Medicare (plans) $27 93%
Node Champva $27 93%
Node Clover Health Mcr Adv $27 93%
Node Devoted Health Mcr Adv $27 93%
Node Va $27 93%
Select Health $27 93%
UnitedHealthcare $27 - $217 93%
Veterans Eval Services $27 93%
Victory Health $27 93%
Viva Health $27 - $191 93%
Aetna $28 - $129 96%
Node Wellcare Mcr Adv $28 96%
Alamed $41 141%
Ambetter / Centene $41 141%
Node Us Dept Of Labor $42 145%
First Health $47 - $278 162%
Healthspring $48 165%
Novanet $48 165%
Blue Cross Blue Shield $67 231%
Self Pay $68 - $111 234%
Bp Health Advocate $113 - $116 389%
Ag Administrators $158 - $162 544%
Choicecare $158 - $162 544%
Drummond $158 - $162 544%
American Employee Alliance $180 - $185 619%
Healthchoice $226 - $278 778%
Value Options $226 - $232 778%
Multiplan $275 - $324 946%
Blue Bell Creameries $316 - $324 1087%
Natl Comp Care $338 - $347 1163%
Usa Ppo $338 - $347 1163%
Coventry Work Comp Al $353 - $362 1215%
Alabama Wc $383 - $394 1318%
Cal-Med $383 - $394 1318%
Corvel $383 - $394 1318%
Associated Admin $406 - $417 1397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3690 Grandview Parkway, Birmingham, AL 35243
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals