CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Banner-University Medical Center South Campus

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $78
Cash Discount Price: $29
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Banner-University Medical Center South Campus is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $29. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.68x the Medicare baseline. Located in 2800 East Ajo Way, Tucson, AZ.

Cash / Self-Pay

$29

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $29 (100%)

Insurance Median: $78 (268%)

Cash: $29 (100% of Medicare)

Ins. Median: $78 (268% 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 268% of the Medicare baseline (a markup of 168%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$31 - $90	107%
Arizona Physicians Ipa	$40	138%
Health Choice Arizona, Inc.	$40 - $78	138%
Health Net	$40 - $84	138%
Mercy Care	$40	138%
University Of Arizona (Kasser Medical Treatment Center)	$55	189%
Arizona Priority Care	$62	213%
National Healthcare Solutions Inc (Nhsi) And Vip Universal Medical Insurance Group (Vumi)	$70	241%
Plotkin Health	$70	241%
Blue Cross Blue Shield	$71 - $135	244%
Oscar Health Plan	$78	268%
Quiktrip Corporation	$84	289%
Provider Network Of America	$117	403%
Arizona Medical Network	$125	430%
Cigna	$225	774%
UnitedHealthcare	$268	922%

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 $29.
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 Banner-University Medical Center South Campus 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.