CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Memorial Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $153
Cash Discount Price: $255
vs. Medicare Baseline: 5.26x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Memorial Medical Center is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.26x the Medicare baseline. Located in 701 N First St, Springfield, IL.

Cash / Self-Pay

$255

Average discount available for prompt cash payment at this facility.

Insurance Median

$153

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: $255 (877%)

Insurance Median: $153 (526%)

Cash: $255 (877% of Medicare)

Ins. Median: $153 (526% 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 526% of the Medicare baseline (a markup of 426%). 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
Medicaid / KanCare	$9 - $111	31%
Molina	$9 - $113	31%
Veterans Administration	$20	69%
Blue Cross Blue Shield	$25 - $255	86%
Aetna	$27 - $194	93%
Health Alliance	$27 - $166	93%
Medicare (plans)	$27 - $255	93%
Tricare	$27	93%
UnitedHealthcare	$27 - $158	93%
Humana	$29 - $153	100%
Commercial Workers Compensation	$90	310%
Illinois Workers Compensation	$94	323%
Current Health Network Ppo	$115	396%
Healthlink	$128 - $161	440%
Cigna	$134	461%
Phcs/Multiplan	$138 - $153	475%
6 Degrees Health	$153	526%
Hopetrust	$153	526%
Hst	$153	526%
Magellan	$153	526%
Consociate	$166	571%
Hfn	$166	571%
Preferred Plan	$191	657%
Soi Mcfarland	$191	657%
Soi Rushville	$191	657%
Corvel	$204	702%
Methodist First Choice	$204	702%
Mutual Medical Plans	$217	747%
Liability	$255	877%

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 $255.
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 Medical 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.