CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Clarinda Regional Health Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $62
  • Cash Discount Price: $70
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Clarinda Regional Health Center is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.13x the Medicare baseline. Located in 220 Essie Davison Drive, Clarinda, IA.
Cash / Self-Pay
$70

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $70 (241%)
Insurance Median: $62 (213%)
Cash: $70 (241% of Medicare)
Ins. Median: $62 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Ambetter / Centene $57 - $61 196%
Molina Mcr Adv-All Plans $57 196%
UnitedHealthcare $57 - $112 196%
Blue Cross Blue Shield $58 - $94 200%
Ia Total Care Mcaid-All Plans $62 213%
Geha-All Plans $110 379%
Coventry Health-All Other Plans $111 382%
Midlands Choice-All Plans $112 385%
Multiplan-All Plans $112 385%
Amerigroup Ia Mcaid-All Plans $118 406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 220 Essie Davison Drive, Clarinda, IA 51632
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals