CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Rush Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $169
Cash Discount Price: $189
vs. Medicare Baseline: 5.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Rush Memorial Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $189. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.82x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$189

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $189 (650%)

Insurance Median: $169 (582%)

Cash: $189 (650% of Medicare)

Ins. Median: $169 (582% 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 582% of the Medicare baseline (a markup of 482%). 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
Health Net	$74	255%
Caresource Mcr Adv	$78	268%
My True Advantage - All Plans	$78	268%
UnitedHealthcare	$78 - $202	268%
Aetna	$79 - $232	272%
Humana	$79 - $232	272%
Blue Cross Blue Shield	$80 - $184	275%
Today'S Option Mcr Adv-All Plans	$80	275%
Viant Beech St Mcr Adv	$80	275%
Caresource Marketplace-All Other Plans	$124 - $125	427%
Cigna	$201 - $202	692%
Phcs-All Plans	$201 - $202	692%
Consumers Life Ins-All Plans	$226 - $227	778%
Coventry/First Health-All Plans	$226 - $227	778%
Sagamore-All Plans	$231 - $232	795%
Siho-All Plans	$231 - $232	795%
Multiplan-All Plans	$233 - $234	802%
Community Health Alliance-All Plans	$236 - $237	812%
Encore Health Services-All Plans	$246 - $247	847%

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 $189.
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 Rush 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.