CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: HCA Healthone Presbyterian St Luke's

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $62
  • Cash Discount Price: $243
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at HCA Healthone Presbyterian St Luke's is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $243. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.13x the Medicare baseline. Located in 1719 E 19Th Ave, Denver, CO.
Cash / Self-Pay
$243

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $243 (836%)
Insurance Median: $62 (213%)
Cash: $243 (836% of Medicare)
Ins. Median: $62 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
UnitedHealthcare $22 - $26 76%
Aetna $26 - $138 89%
Blue Cross Blue Shield $26 - $194 89%
Bright Health $26 - $79 89%
Cigna $26 - $168 89%
Devoted Health $26 - $30 89%
Humana $26 - $30 89%
Kaiser National Transplant $26 - $126 89%
Mutual Of Omaha $26 - $30 89%
Rocky Mountain Health $26 - $30 89%
Total Longterm Care $26 - $30 89%
Triwest Health Alliance $26 - $30 89%
United $26 - $118 89%
Innovage Pace $27 - $31 93%
Kaiser $27 - $68 93%
Wellcare $27 - $31 93%
Delaware Life Insurance $28 - $32 96%
Vail Health $35 - $40 120%
Emerging Therapy Solutions $111 - $168 382%
Colorado Program For Children With Special Needs $118 - $133 406%
Western Plains Community Health $150 - $170 516%
Multiplan $162 - $236 557%
Northcare $162 - $183 557%
Physician Health Partners $162 - $183 557%
Pinnacol Workers Comp $173 - $196 595%
Medical Development International $185 - $209 637%
Prime Health $208 - $236 716%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1719 E 19Th Ave, Denver, CO 80218
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - State
  • Hospital Type: Acute Care Hospitals