CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Sarah Bush Lincoln Health Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $175
  • Cash Discount Price: $236
  • vs. Medicare Baseline: 6.02x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Sarah Bush Lincoln Health Center is $175. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $236. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 6.02x the Medicare baseline. Located in 1000 Health Center Drive P O Box 372, Mattoon, IL.
Cash / Self-Pay
$236

Average discount available for prompt cash payment at this facility.

Insurance Median
$175

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: $236 (812%)
Insurance Median: $175 (602%)
Cash: $236 (812% of Medicare)
Ins. Median: $175 (602% 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 602% of the Medicare baseline (a markup of 502%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $28 - $212 96%
Bc Comm Mmai $28 96%
Beacon Health Options Behav-All Plans $28 96%
Hlth Alliance Mcr Adv $28 96%
Humana $28 - $29 96%
Meridian Mmai-All Other Plans $28 96%
Molina Mmai-All Other Plans $28 96%
Tricare $28 96%
UnitedHealthcare $28 - $196 96%
Va Ccn-All Plans $28 96%
Wellcare Med Adv-All Plans $28 96%
Bc Med Adv Ppo/Hmo $29 100%
Bc Comm Care Mcaid $45 155%
Hlth Alliance Mcaid $45 155%
Meridian Mcaid $45 155%
Molina Mcaid $45 155%
Plain Church Mg-All Plans $94 323%
Mennonite-All Plans $106 365%
Eiu Athlete-All Other Plans $165 568%
Healthscope-All Plans $175 602%
Rural King-All Plans $175 602%
Blue Cross Blue Shield $186 - $189 640%
Consociate-All Plans $189 650%
Hope Trust-All Plans $189 650%
Eiu Student $194 668%
Allied National-All Plans $198 681%
Companion Life-All Plans $198 681%
Hlth Alliance-All Other Plans $198 681%
First Health-All Plans $201 692%
Innovative Hlthware-All Plans $201 692%
Healthlink Hmo $203 699%
Healthlink Ppo - All Other Plans $203 699%
Multiplan-All Plans $203 699%
Cigna $212 730%
Cphp-All Plans $212 730%
Beech Street-All Plans $217 747%
Hfn-All Plans $217 747%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Health Center Drive P O Box 372, Mattoon, IL 61938
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals