CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Lower Keys Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $245
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 8.43x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Lower Keys Medical Center is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 8.43x the Medicare baseline. Located in 5900 College Road, Key West, FL.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$245

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: $118 (406%)
Insurance Median: $245 (843%)
Cash: $118 (406% of Medicare)
Ins. Median: $245 (843% 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 843% of the Medicare baseline (a markup of 743%). 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
Molina $21 72%
Tricare $28 96%
Veterans Eval Services $28 96%
Blue Cross Blue Shield $30 - $382 103%
Humana $30 103%
Medicare (plans) $30 103%
Node Champva $30 103%
Node Non Par Hospice Agree $30 103%
Node United Behavioral Va Ccn $30 103%
Node Va $30 103%
Ultimate Health $30 103%
UnitedHealthcare $30 - $294 103%
Correct Care Solutions $33 114%
Node Us Dept Of Labor $47 162%
Prime Health Work Comp Fl $50 172%
Fl Work Comp $52 179%
Heritage Summit Work Comp Fl $52 179%
State Auto Insurance Fl $60 206%
Self Pay $103 - $134 354%
Simply Healthcare $118 406%
Cigna $226 778%
Aetna $267 919%
Monroe County $287 988%
Evolutions Healthcare Systems $306 - $363 1053%
Keys Energy $306 1053%
Prime Health Ppo $306 1053%
Avmed Health Plan $325 1118%
Direct Healthcare $382 1315%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5900 College Road, Key West, FL 33040
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals