CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Monroe Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $49
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Monroe Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.69x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $27 (93%)
Insurance Median: $49 (169%)
Cash: $27 (93% of Medicare)
Ins. Median: $49 (169% 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
Aetna $28 96%
Blue Cross Blue Shield $28 - $173 96%
Care Source $28 - $173 96%
Medicare (plans) $28 96%
Monroe Medical Group And Managed Health Services $28 - $173 96%
Tricare $28 96%
UnitedHealthcare $28 - $173 96%
Usa Senior Care Network $28 96%
Worthington Christian Fellowship $28 96%
Provider Partners Health Plan $31 107%
Employer Direct Healthcare $39 134%
Corvel Workers Compensation $49 169%
Zelis Healthcare Fka Stratose $53 182%
Americas Choice Provider Network Acpn $54 186%
Multiplan $54 186%
Prime Health Services $54 186%
Three Rivers $54 186%
Encore Health Network Workers Compensation $55 189%
Provider Select $55 189%
Provider Network Of America $56 193%
Workers Compensation $56 193%
Medicaid / KanCare $173 595%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4011 S Monroe Medical Park Blvd, Bloomington, IN 47403
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals