Physical therapy (therapeutic exercise)
Facility: Saint John Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $29
- Cash Discount Price: $27
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| Blue Cross Blue Shield | $27 - $57 | 93% |
| Medicare (plans) | $28 | 96% |
| Medicaid / KanCare | $28 | 96% |
| Tricare | $28 | 96% |
| Cigna | $28 | 96% |
| Aetna | $28 - $42 | 96% |
| Midland Care Connection | $28 | 96% |
| Kansas Superior Select | $28 | 96% |
| UnitedHealthcare | $28 - $39 | 96% |
| Celtic | $29 - $112 | 100% |
| Healthy Blue | $29 | 100% |
| Corizon | $39 | 134% |
| Well Path | $39 | 134% |
| Employer Direct Healthcare | $39 | 134% |
| Centurion | $41 | 141% |
| Naphcare | $43 | 148% |
Consumer Guidance & Cost Commentary
For CPT code 97110, Physical therapy (therapeutic exercise), Saint John Hospital in Leavenworth, KS, lists a gross charge of $278.00. While the facility offers a cash median rate of $27.00, which is significantly lower than the negotiated rates paid by most insurers, patients should be aware that commercial insurance plans often pay much higher amounts. For instance, Celtic insurance pays up to $112 for this service, and Blue Cross Blue Shield pays between $27 and $57. Because the cash price is so low, it may be financially advantageous for patients with high-deductible plans to pay out-of-pocket, provided they can secure a prompt-pay discount before the insurance claim is processed.
It is important to distinguish between the facility's gross charge and the actual amount billed to patients. The Medicare benchmark for this service is $29.06, which serves as a reliable baseline for evaluating pricing fairness, as commercial negotiated rates often exceed this by a wide margin. The facility's median negotiated rate is $29.00, which is nearly identical to the Medicare amount, suggesting a fair pricing structure compared to the gross charge. However, patients should request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Additionally, since the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, patients should verify their network status and dispute any unexpected bills immediately rather than paying them out of fear of credit damage.