CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Kossuth Regional Health Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $123
Cash Discount Price: $118
vs. Medicare Baseline: 4.23x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Kossuth Regional Health Center is $123. 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 4.23x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$118

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $123 (423%)

Cash: $118 (406% of Medicare)

Ins. Median: $123 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
Mercy One - All Plans	$51 - $61	175%
Va Ccn - All Plans	$51 - $61	175%
Amerigroup Mcr Adv - All Other Plans	$52 - $62	179%
Humana	$52 - $61	179%
UnitedHealthcare	$53 - $121	182%
Health Partners New Bus - All Other Plans	$94 - $112	323%
Midlands Choice - All Plans	$94 - $112	323%
Medical Associates - All Plans	$115 - $136	396%
Preferred Health - All Plans	$115 - $136	396%
Aetna	$126 - $155	434%
Multiplan - All Plans	$128 - $152	440%
Health Partners Exisiting Bus	$131 - $155	451%
Molina Mcaid/Chip - All Plans	$139 - $165	478%
Amerigroup Mcaid	$140 - $166	482%
Blue Cross Blue Shield	$191 - $210	657%

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 $118.
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 Kossuth Regional Health Center 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.