CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Anderson Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $43
  • Cash Discount Price: $107
  • vs. Medicare Baseline: 1.48x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Anderson Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $107. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.48x the Medicare baseline. Located in 6800 State Route 162, Maryville, IL.
Cash / Self-Pay
$107

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $107 (368%)
Insurance Median: $43 (148%)
Cash: $107 (368% of Medicare)
Ins. Median: $43 (148% 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.

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
Medicaid / KanCare $13 - $45 45%
Aetna $27 - $126 93%
Humana $27 - $28 93%
Medicare (plans) $27 - $28 93%
Tricare $27 - $28 93%
UnitedHealthcare $27 - $203 93%
Clear Springs Health $28 96%
Devoted Health Ppo $28 96%
Essence $28 - $29 96%
Health Care Service Corporation $35 - $98 120%
Ambetter / Centene $40 138%
Blue Choice $40 138%
Work Comp $40 - $26,600 138%
Hopetrust $70 241%
Healthlink $107 368%
Self Pay $107 - $25,000 368%
Blue Cross Blue Shield $115 - $119 396%
Cigna $150 516%
Mercy Benefit Admin $155 533%
Mercy Aco $160 551%
Multiplan/Phcs $160 551%
Beech Street Corporation $192 661%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6800 State Route 162, Maryville, IL 62062
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals