CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Gunnison Valley Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $96
Cash Discount Price: $96
vs. Medicare Baseline: 3.30x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Gunnison Valley Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $96. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.30x the Medicare baseline. Located in 711 N Taylor St, Gunnison, CO.

Cash / Self-Pay

$96

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $96 (330%)

Insurance Median: $96 (330%)

Cash: $96 (330% of Medicare)

Ins. Median: $96 (330% 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 330% of the Medicare baseline (a markup of 230%). 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
Medicaid / KanCare	$48	165%
Medicare (plans)	$55 - $56	189%
Gunnison County Coroner Op Only	$57 - $58	196%
Gunnison County Sheriff Op & Profee Only	$57 - $58	196%
Ebms Hdhp	$67 - $68	231%
Tetwp Op & Profee Only-All Plans	$67 - $68	231%
U Of Co Transplant-All Plans	$67 - $68	231%
Ebms Ppo Plan-All Other Plans	$78 - $79	268%
Gunnison County Employees-All Other Plans	$90 - $91	310%
Scottish Rites-All Plans	$90 - $91	310%
Elap Employers-All Plans	$95 - $96	327%
Blue Cross Blue Shield	$98 - $99	337%
Apostrophe-All Plans	$101 - $102	348%
Multiplan-All Plans	$104 - $105	358%
Rocky Mountain Health-All Plans	$106 - $108	365%
UnitedHealthcare	$106 - $108	365%
Aetna	$108 - $109	372%
Cofinity-All Plans	$108 - $109	372%
Cigna	$110 - $111	379%

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 $96.
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 Gunnison Valley 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.