CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Bluffton Regional Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $116
  • Cash Discount Price: $79
  • vs. Medicare Baseline: 3.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Bluffton Regional Medical Center is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.99x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$79

Average discount available for prompt cash payment at this facility.

Insurance Median
$116

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: $79 (272%)
Insurance Median: $116 (399%)
Cash: $79 (272% of Medicare)
Ins. Median: $116 (399% 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 399% of the Medicare baseline (a markup of 299%). 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.

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
Amish Aid $20 - $81 69%
Physicians Health Plan $20 - $51 69%
Self Pay $20 - $185 69%
Theramatrix $22 76%
Lutheran Preferred Network $25 - $269 86%
UnitedHealthcare $25 - $186 86%
Cigna $26 - $119 89%
Php $26 - $50 89%
Php Freedom Network $26 - $56 89%
Tricare $26 89%
Aetna $27 - $150 93%
Blue Cross Blue Shield $27 - $186 93%
Medicare (plans) $27 93%
Node Caresource Mcr Adv $27 93%
Node Iu Health Mcr Adv $27 93%
Node Mhs Mcr Adv $27 93%
Department Of Veterans Affairs $28 96%
Humana $28 - $186 96%
Node Devoted Health Mcr Adv $28 96%
Node Non Par Hospice Agree $28 96%
Node Va $28 96%
Northeast Hospice $28 96%
Veterans Eval Services $28 96%
County Jail Health Care $29 100%
In Dept Of Correction $29 100%
Node Pphp Mcr Adv $29 100%
Php Management Systems $32 - $130 110%
Lutheran Trma $33 - $151 114%
Encore Ppo $41 - $164 141%
Lutheran Advanced Network $42 145%
Lutheran Three Rivers Preferred Plus 150 $42 145%
Sagamore Sebt $42 - $172 145%
Us Department Of Labor $43 148%
Sagamore Health Newtork Inc $44 - $180 151%
Lutheran Three Rivers Preferred Plus 175 $49 169%
Encore Work Comp In $50 172%
Prime Health Services $50 - $252 172%
Consumer Life $51 - $208 175%
Ahg Dana Employees $54 - $218 186%
Lutheran Northwest Health Preferred $56 193%
Managed Health Services Exchange $56 193%
Workers Compensation $56 193%
Align Networks $58 - $235 200%
Private Healthcare Systems Inc $62 - $252 213%
Medrisk In Work Comp $65 224%
Multiplan $66 - $269 227%
Encore Kba Epo $67 231%
Encore Health Network $68 - $302 234%
Advantage 360 $69 - $279 237%
Community Health Alliance $71 - $286 244%
First Health $71 - $289 244%
Allied Benefit Systems $75 - $302 258%
Cardinal Health Alliance $75 - $302 258%
Ppom $75 - $302 258%
Encore Kba Ppo $84 289%
Caresource $186 640%
Medicaid / KanCare $186 640%
Mhs $186 640%
Mhs In Hip $186 640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals