CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Jacksonville Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $148
Cash Discount Price: $251
vs. Medicare Baseline: 5.09x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Jacksonville Memorial Hospital is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.09x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $251 (864%)

Insurance Median: $148 (509%)

Cash: $251 (864% of Medicare)

Ins. Median: $148 (509% 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 509% of the Medicare baseline (a markup of 409%). 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 Healthcare	$9 - $111	31%
Blue Cross Blue Shield	$26 - $255	89%
Coventry	$28 - $40	96%
Health Alliance	$28 - $173	96%
Humana	$28 - $218	96%
Medicare (plans)	$28 - $40	96%
Tricare	$28 - $46	96%
UnitedHealthcare	$29 - $184	100%
Corvel/Corcare	$49 - $81	169%
Illinois Workers Compensation	$53 - $85	182%
Commercial Workers Compensation	$81	279%
Health Alliance Mh Employee Plan	$114 - $117	392%
Current Health Network	$136 - $191	468%
6 Degrees Health	$148 - $153	509%
Hope Trust	$148 - $153	509%
Hst	$148 - $153	509%
Cigna	$171 - $177	588%
Aetna	$173 - $204	595%
Healthlink	$210 - $217	723%
Phcs/Multiplan	$222 - $230	764%
Hfn	$235 - $242	809%
Liability	$247 - $255	850%

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 $251.
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 Jacksonville Memorial Hospital 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.