CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Franciscan Health Mooresville

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $125
Cash Discount Price: $52
vs. Medicare Baseline: 4.30x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Franciscan Health Mooresville is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $52. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.30x the Medicare baseline. Located in 1201 Hadley Rd, Mooresville, IN.

Cash / Self-Pay

$52

Average discount available for prompt cash payment at this facility.

Insurance Median

$125

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: $52 (179%)

Insurance Median: $125 (430%)

Cash: $52 (179% of Medicare)

Ins. Median: $125 (430% 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 430% of the Medicare baseline (a markup of 330%). 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
Research/Grant [2012]	$5	17%
Medicare (plans)	$28 - $31	96%
Aetna	$55 - $172	189%
Blue Cross Blue Shield	$55 - $56	189%
Managed Care [2000]	$55 - $237	189%
Unicare [1150]	$55 - $56	189%
Workers Comp [1172]	$56	193%
Commercial [2001]	$65 - $249	224%
UnitedHealthcare	$96 - $151	330%
United Medical Resources [1158]	$98 - $151	337%
United Medical Resources [1301]	$98 - $151	337%
Cigna	$103 - $159	354%
Great West Insurance [1055]	$105 - $162	361%
Humana	$113 - $174	389%
Mdwise [1175]	$186	640%
Medicaid / KanCare	$186 - $224	640%
Managed Health Services [1302]	$192	661%

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 $52.
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 Franciscan Health Mooresville 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.