CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Baptist Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $59
Cash Discount Price: $25
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Baptist Hospital is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.03x the Medicare baseline. Located in 123 Baptist Way, Pensacola, FL.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $25 (86%)

Insurance Median: $59 (203%)

Cash: $25 (86% of Medicare)

Ins. Median: $59 (203% 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 203% of the Medicare baseline (a markup of 103%). 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	$20 - $151	69%
Pensacola	$22 - $27	76%
Cha Health Plan	$23	79%
UnitedHealthcare	$23 - $234	79%
Fl Community Care Ltc	$24	83%
Humana	$24 - $38	83%
Mh Sunshine Mcaid	$24	83%
Staywell	$24	83%
Sunshine Health	$24	83%
Simply Healthcare Healthy Kids	$26	89%
Fl Blue	$31 - $335	107%
Uwf Athletes	$34 - $117	117%
Hospice Covenant	$37	127%
Medicare (plans)	$37	127%
Healthspring Of Fl Al	$38	131%
Mh Wellcare	$39	134%
Wellcare	$39	134%
Hospice Regency	$44 - $54	151%
Bc Fl	$46 - $244	158%
Cigna	$70 - $180	241%
Hospice Emerald Coast	$74 - $90	255%
Escambia	$88 - $108	303%
Private Healthcare	$96 - $117	330%
First Health	$102 - $125	351%
Wc Corvel	$105 - $171	361%
Choicecare	$110 - $135	379%
Mh Choicecare	$110 - $135	379%
Multiplan	$131 - $160	451%

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 $25.
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 Baptist 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.