CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: USA Health Children's & Women's Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $56
Cash Discount Price: $100
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at USA Health Children's & Women's Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 1700 Center Street, Mobile, AL.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$56

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: $100 (344%)

Insurance Median: $56 (193%)

Cash: $100 (344% of Medicare)

Ins. Median: $56 (193% 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
Magnolia Health	$24	83%
Truecare	$24	83%
UnitedHealthcare	$24 - $75	83%
Molina Chip	$26	89%
Blue Cross Blue Shield	$28	96%
Aetna	$29 - $76	100%
Devoted Health	$29 - $97	100%
Humana	$29 - $90	100%
Viva Health	$29 - $70	100%
Wellcare	$29	100%
Molina Marketplace	$32	110%
Ambetter / Centene	$35	120%
Mississippi Physicians Care Network (Mpcn)	$39	134%
Cigna	$41 - $150	141%
Central Healthcare Services	$43 - $70	148%
Multiplan	$56 - $97	193%
Novanet	$77 - $125	265%

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 $100.
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 USA Health Children's & Women's Hospital 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.