CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Johnson Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $135
  • Cash Discount Price: $93
  • vs. Medicare Baseline: 4.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Johnson Memorial Hospital is $135. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.65x the Medicare baseline. Located in 201 Chestnut Hill Road, Stafford Springs, CT.
Cash / Self-Pay
$93

Average discount available for prompt cash payment at this facility.

Insurance Median
$135

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: $93 (320%)
Insurance Median: $135 (465%)
Cash: $93 (320% of Medicare)
Ins. Median: $135 (465% 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 465% of the Medicare baseline (a markup of 365%). 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
Aetna $30 - $136 103%
Blue Cross Blue Shield $30 - $117 103%
Medicare (plans) $30 - $32 103%
UnitedHealthcare $30 - $369 103%
Cca Senior Care Options $31 107%
Cigna $31 - $160 107%
Fallon Health $40 138%
Connecticut Dept Of Correction $55 - $59 189%
Claimdoc $64 220%
Diversified Administrators $64 220%
Innovative Health Plan Ii $64 220%
Centivo $71 244%
Health New England $106 - $114 365%
Bcn Domestic $117 403%
Blue Benefit Administrators Of Massachusetts $117 403%
Blue Care Network $117 403%
Blue Distinction Transplant $117 403%
Blue Shield - Ca $117 403%
Blue Shield - Id (Regence) $117 403%
Blue Shield - Ny Highmark Northeastern $117 403%
Blue Shield - Ny Highmark Western $117 403%
Blue Shield - Pa (Highmark) $117 403%
Blue Shield - Wa (Regence) $117 403%
Health Choices $117 403%
Kaiser Domestic $117 403%
Pre-Employment $117 403%
Unicare $117 403%
Wc Domestic $117 403%
Wellpoint $117 403%
1199 National Benefit Fund $127 - $136 437%
Allied Benefit Systems $127 - $136 437%
Gravie Admin Services $127 - $136 437%
Hap $127 - $136 437%
Luminare Health $127 - $136 437%
Meritain $127 - $136 437%
Nippon Life Ins $127 - $136 437%
Webtpa $127 - $136 437%
Prime Health Services $130 - $140 447%
Allied National Global Care $135 - $145 465%
Asrm - Reliance Standard Life Insurance $135 - $145 465%
Christian Care Ministry $135 - $145 465%
Dean Health $135 - $145 465%
Family Life Insurance Company $135 - $145 465%
Ghc Scw $135 - $145 465%
International Benefit Administrators $135 - $145 465%
Lifetime Benefit Solutions $135 - $145 465%
Manhattan Life $135 - $145 465%
Medi Share $135 - $145 465%
Multiplan $135 - $145 465%
Mvp $135 - $145 465%
Pai $135 - $145 465%
Pan-American Life $135 - $145 465%
Paramount Hmo $135 - $145 465%
Phcs $135 - $145 465%
Trinity Health Share $135 - $145 465%
Health Smart $139 - $149 478%
Allegiance $149 - $160 513%
Health Partners $149 - $160 513%
Magnacare $149 - $160 513%
United Behavioral Health Eap $163 - $175 561%
Connecticare $242 - $314 833%
Geha $369 1270%
Harvard Pilgrim Healthcare $369 1270%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 Chestnut Hill Road, Stafford Springs, CT 06076
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals