CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Boulder Community Health

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $88
  • Cash Discount Price: $139
  • vs. Medicare Baseline: 3.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Boulder Community Health is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $139. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.03x the Medicare baseline. Located in 4747 Arapahoe Avenue, Boulder, CO.
Cash / Self-Pay
$139

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $139 (478%)
Insurance Median: $88 (303%)
Cash: $139 (478% of Medicare)
Ins. Median: $88 (303% 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 303% of the Medicare baseline (a markup of 203%). 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
Humana $21 - $30 72%
Blue Cross Blue Shield $28 - $165 96%
Aetna $30 - $241 103%
Clear Spring $30 103%
Devoted Health $30 - $111 103%
Health Spring $30 - $60 103%
Medicare (plans) $30 - $105 103%
Rocky Mountain Health Maintenance Organization $30 - $219 103%
UnitedHealthcare $30 - $418 103%
Medicaid / KanCare $33 114%
Kaiser Ppo $35 - $70 120%
Kaiser Public Option $35 - $57 120%
Colorado Access $36 - $42 124%
Select Health Colorado Public Option $36 - $105 124%
Select Health Value Network $36 - $105 124%
Cigna $37 - $246 127%
Beech Street Community Medical Associates $46 158%
Multiplan $48 - $194 165%
Phcs $48 - $194 165%
Kaiser $69 237%
Rocky Mountain Health Maintenance Organization Private Plan $194 668%
Integrated Health Plans Bch $208 716%
Casualty Management Network, Prime Health Services Behavioral Health $235 809%
Mines And Associates $235 809%
Three Rivers Provider Network $235 809%
Zelis (Profee) $235 809%
Casualty Management Network, Prime Health Services Community Medical Associates $249 857%
National Preferred Provider Network $249 857%
Rockport Healthcare Group Community Medical Associates $249 857%
Usa $249 857%
Rockport Healthcare Group Bch $258 888%
Health Payors Organization $263 905%
Health Management Network Bch Community Medical Associates $266 915%
Health Management Network Community Medical Associates $266 915%
National Provider Network $269 926%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4747 Arapahoe Avenue, Boulder, CO 80304
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals