CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: HCA Healthone Spalding Rehabilitation

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $97
Cash Discount Price: $345
vs. Medicare Baseline: 3.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at HCA Healthone Spalding Rehabilitation is $97. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.34x the Medicare baseline. Located in 900 Potomac St, Aurora, CO.

Cash / Self-Pay

$345

Average discount available for prompt cash payment at this facility.

Insurance Median

$97

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: $345 (1187%)

Insurance Median: $97 (334%)

Cash: $345 (1187% of Medicare)

Ins. Median: $97 (334% 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 334% of the Medicare baseline (a markup of 234%). 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	$26 - $175	89%
Blue Cross Blue Shield	$26 - $235	89%
Bright Health	$26 - $30	89%
Cigna	$26 - $221	89%
Devoted Health	$26 - $30	89%
Humana	$26 - $30	89%
Mutual Of Omaha	$26 - $30	89%
Rocky Mountain Health	$26 - $30	89%
Total Longterm Care	$26 - $30	89%
Triwest Health Alliance	$26 - $276	89%
United	$26 - $155	89%
Innovage Pace	$27 - $31	93%
Kaiser	$27 - $206	93%
Wellcare	$27 - $31	93%
Delaware Life Insurance	$28 - $32	96%
Vail Health	$30 - $52	103%
Western Plains Community Health	$128 - $224	440%
Multiplan	$138 - $311	475%
Pinnacol Workers Comp	$147 - $259	506%
Prime Health	$177 - $311	609%

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 $345.
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 HCA Healthone Spalding Rehabilitation 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.