CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $157
Cash Discount Price: $171
vs. Medicare Baseline: 5.40x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at University of Iowa Health Care Medical Center Down is $157. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $171. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.40x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$171

Average discount available for prompt cash payment at this facility.

Insurance Median

$157

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: $171 (588%)

Insurance Median: $157 (540%)

Cash: $171 (588% of Medicare)

Ins. Median: $157 (540% 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 540% of the Medicare baseline (a markup of 440%). 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
Iowa Total Care	$25 - $28	86%
Molina Healthcare	$25 - $27	86%
Wellpoint (Amerigroup)	$25 - $29	86%
Aetna	$27 - $225	93%
Medical Associates	$27 - $200	93%
UnitedHealthcare	$27 - $226	93%
Blue Cross Blue Shield	$28 - $143	96%
Healthpartners	$28 - $253	96%
Immergrun	$31 - $74	107%
Quad City Community Healthcare	$48 - $224	165%
Aplos Health Plan	$70 - $238	241%
Oscar Health	$77 - $188	265%
Midlands Choice	$81 - $194	279%
Great River Health Systems	$86 - $209	296%
Sedgwick	$98 - $238	337%
Global Excel	$105 - $253	361%
Sanford Health Plan	$105 - $253	361%
Employee Benefit Systems	$108 - $268	372%
Sisco	$108 - $262	372%
Healthsmart	$111 - $268	382%
Hfn	$113 - $274	389%
Multiplan	$113 - $274	389%

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 $171.
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 University of Iowa Health Care Medical Center Down 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.