CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Marion Communtiy Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $51
  • Cash Discount Price: $375
  • vs. Medicare Baseline: 1.75x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Marion Communtiy Hospital is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $375. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.75x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$375

Average discount available for prompt cash payment at this facility.

Insurance Median
$51

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: $375 (1290%)
Insurance Median: $51 (175%)
Cash: $375 (1290% of Medicare)
Ins. Median: $51 (175% 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.

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
Devoted Health $25 - $29 86%
Humana $25 - $83 86%
Ndms Definitive Care $25 - $29 86%
United $25 - $186 86%
Va Purchased Care Program $25 - $29 86%
Veterans Evaluation Services $25 - $29 86%
Wellmed $25 - $29 86%
Blue Cross Blue Shield $26 - $29 89%
Freedom Optimum $26 - $29 89%
Sunshine State $26 - $30 89%
Wellcare $26 - $30 89%
Align Senior Care $27 - $31 93%
American Health Plan $27 - $30 93%
Avmed $27 - $116 93%
Cigna $27 - $172 93%
Florida Complete Care $27 - $31 93%
Gold Kidney Of Florida $27 - $31 93%
Secur $27 - $31 93%
Aetna $28 - $124 96%
Centurion $28 - $31 96%
Clear Spring Health $28 - $31 96%
Simply Healthcare $28 - $53 96%
Careplus $29 - $33 100%
Ultimate Health Plan $29 - $33 100%
Longevity Health Plan $30 - $34 103%
Corvel Corporation $32 110%
Prime Health $33 114%
Careworks (Rockport Community) $34 117%
Marion County Schools $34 117%
Molina Healthcare $42 - $132 145%
Evolutions $51 - $95 175%
Evolutions Healthcare $51 - $95 175%
Naphcare $53 - $69 182%
University Ma Federal Corrections $53 - $60 182%
Wellpath $53 - $69 182%
Sunshine State Health Plan $57 - $105 196%
Plotkin Health $111 - $207 382%
Prime Health Sheriff $111 - $207 382%
Multiplan $173 - $322 595%
Ppo Next $189 - $351 650%
Novanet $200 - $372 688%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals