CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Medstar Washington Hospital Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $96
  • Cash Discount Price: $130
  • vs. Medicare Baseline: 3.30x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Medstar Washington Hospital Center is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $130. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.30x the Medicare baseline. Located in 110 Irving Street Nw, Washington, DC.
Cash / Self-Pay
$130

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: $130 (447%)
Insurance Median: $96 (330%)
Cash: $130 (447% 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.

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
Carefirst Advantage Inc $32 110%
Mamsi $32 110%
Tricare $32 110%
UnitedHealthcare $32 - $58 110%
Aetna $33 - $92 114%
Health Care Service Corporation $34 117%
Humana $34 117%
Kaiser Permanente $34 - $100 117%
Medstar Family Choice Inc $96 - $337 330%
Cigna $119 409%
Pfc $130 447%
Ncppo Healthlink Ppo $150 516%
Private Healthcare Systems (Phcs) $160 551%
First Health $170 585%
Carefirst Blue Choice Inc $232 798%
Amerigroup $337 1160%
Amerihealth Caritas District Of Columbia $337 1160%
Hscsn $337 1160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 110 Irving Street Nw, Washington, DC 20010
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals