Physical therapy (therapeutic exercise)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $28
- Cash Discount Price: $46
- vs. Medicare Baseline: 0.96x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $25 - $30 | 86% |
| UnitedHealthcare | $25 - $48 | 86% |
| Tricare | $26 | 89% |
| Medica Contracted [320239] | $26 | 89% |
| Humana | $26 - $27 | 89% |
| Aetna | $26 - $60 | 89% |
| Home State Health Plan Contracted [320187] | $27 | 93% |
| Halo Hcr Inc Hospice [20432] | $27 | 93% |
| Medicare (plans) | $27 | 93% |
| Dept Of Veteran Affairs Contracted [320106] | $27 | 93% |
| Kindful Hospice Contracted [320434] | $27 | 93% |
| Pace Of The Ozarks Contracted [320518] | $27 | 93% |
| Blue Cross Blue Shield | $27 - $69 | 93% |
| Halo Hcr Inc Hospice Contracted [320432] | $27 | 93% |
| Mercy Hospice Okc [20252] | $27 | 93% |
| Elara Caring Aspire Hospice [20433] | $27 | 93% |
| Kindful Hospice [20434] | $27 | 93% |
| Cross Timbers Hospice [20098] | $27 | 93% |
| Ambetter / Centene | $27 | 93% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $28 | 96% |
| Health Choice Contracted [320166] | $45 | 155% |
| United Medical Resources Contracted [320454] | $48 | 165% |
| Cigna | $49 - $55 | 169% |
| Providrs Care Network Contracted [320484] | $52 | 179% |
| Auxiant Contracted [320462] | $57 | 196% |
| Yuzu Health Contracted [320521] | $57 | 196% |
| Ebms Contracted [320493] | $57 | 196% |
| American Healthcare Alliance Contracted [320020] | $57 | 196% |
| Mercy Benefit Admin Contracted [320251] | $57 | 196% |
| Healthlink Contracted [320179] | $57 | 196% |
| Reflect Health Contracted [320492] | $57 | 196% |
| Aither Health Contracted [320449] | $57 | 196% |
| Workers Comp [20426] | $57 | 196% |
| Edison Health Solutions Contracted [320502] | $57 | 196% |
| Imagine 360 Contracted [320494] | $57 | 196% |
| First Health Contracted [320128] | $60 | 206% |
Consumer Guidance & Cost Commentary
For the Physical therapy (therapeutic exercise) service (CPT 97110), Mercy Hospital Pittsburg, Inc. lists a cash median of $46.00, which is significantly lower than the facility's gross charge of $71.00. While many commercial payers negotiate rates ranging from $25 to $69, the cash price often represents a more affordable option for patients with high-deductible plans or those without insurance, as it bypasses the administrative overhead and multi-layered structures that inflate commercial negotiated rates. Patients should verify their specific plan's deductible status before scheduling, as paying the cash rate upfront can sometimes result in immediate coverage without waiting for annual deductible thresholds to be met.
To understand the true cost of this service, it is essential to compare rates against the Medicare benchmark, which serves as the federal government's objective baseline for healthcare pricing. The Medicare allowed amount for this procedure is $29.06, and while the facility's median negotiated rate is $28.00, the gross charge of $71.00 represents a substantial markup relative to this baseline. Commercial rates often average 200% to 300% of Medicare, whereas fair pricing is typically defined as 120% to 150% of the Medicare rate. Because the facility is a voluntary non-profit church-owned hospital, patients are encouraged to contact the billing department directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed by bypassing the costly insurance claims processing cycle.