CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Dupont Hospital LLC

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $66
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Dupont Hospital LLC is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.27x the Medicare baseline. Located in 2520 E Dupont Rd, Fort Wayne, IN.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $62 (213%)
Insurance Median: $66 (227%)
Cash: $62 (213% of Medicare)
Ins. Median: $66 (227% 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 227% of the Medicare baseline (a markup of 127%). 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
Physicians Health Plan $20 - $125 69%
Amish Aid $22 - $87 76%
Self Pay $22 - $146 76%
Lutheran Preferred $25 - $194 86%
UnitedHealthcare $25 - $186 86%
Tricare $26 89%
Aetna $27 - $145 93%
Blue Cross Blue Shield $27 - $186 93%
Cigna $27 - $118 93%
Humana $27 - $186 93%
Medicare (plans) $27 93%
Node Mhs Mcr Adv $27 93%
Department Of Veterans Affairs $28 96%
Iu Health $28 96%
Node Devoted Health Mcr Adv $28 96%
Node Non Par Hospice Agree $28 96%
Node Va $28 96%
Php Freedom Network $28 - $59 96%
Veterans Eval Services $28 96%
In Dept Of Correction $29 100%
Node Pphp Mcr Adv $29 100%
Encore Ppo $42 - $162 145%
Lutheran Advanced Network $42 145%
Lutheran Network $42 - $162 145%
Lutheran Preferred Fixed 2 $42 145%
Managed Health Services $42 - $186 145%
Us Department Of Labor $43 148%
Medical Mutual Of Oh $44 - $172 151%
Align In Work Comp $45 155%
Sagamore $45 - $95 155%
Encore Work Comp In $50 172%
Prime Health Services $50 - $243 172%
In Work Comp $56 193%
Frontpath $66 - $259 227%
Encore Kba Epo $67 231%
Encore Health Network $68 - $292 234%
Advantage Health Solutions $69 - $269 237%
Multiplan $71 - $292 244%
Allied Benefit Systems $75 - $292 258%
Encore Kba Ppo $84 289%
Caresource $186 640%
Medicaid / KanCare $186 640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2520 E Dupont Rd, Fort Wayne, IN 46825
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals