CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Memorial Hospital and Manor

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $127
Cash Discount Price: $116
vs. Medicare Baseline: 4.37x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Memorial Hospital and Manor is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $116. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.37x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.

Cash / Self-Pay

$116

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $116 (399%)

Insurance Median: $127 (437%)

Cash: $116 (399% of Medicare)

Ins. Median: $127 (437% 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 437% of the Medicare baseline (a markup of 337%). 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
Tricare	$26	89%
Aetna	$28 - $148	96%
Humana	$28 - $132	96%
Medicare (plans)	$28	96%
Wellcare_Plan	$28	96%
Ambetter / Centene	$36	124%
Alliant_Plan	$44	151%
Amerigroup_Plan	$104	358%
Medicaid / KanCare	$104	358%
Peach_State_Health_Plan_Plan	$104	358%
Caresource_Plan	$109	375%
Blue Cross Blue Shield	$127	437%
Uhc_Plan	$130	447%
Novanet_Plan	$132	454%
Cigna	$137	471%
Private_Healthcare_Systems_Plan	$140	482%
Multiplan_Plan	$148	509%
Corvel_Plan	$157	540%
Tnga_Plan	$450	1549%

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 $116.
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 Memorial Hospital and Manor 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.