Physical therapy (therapeutic exercise)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $68
- Cash Discount Price: $50
- vs. Medicare Baseline: 2.34x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 234% of the Medicare baseline (a markup of 134%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Web Tpa [2115] | $68 | 234% |
| Blue Cross Blue Shield | $68 | 234% |
| Aetna | $68 | 234% |
| Oncology Patient Assistance Programs [2295] | $68 | 234% |
| Lucent Health [6000] | $68 | 234% |
| Black Lung [6055] | $68 | 234% |
| Hooray Health [8000] | $68 | 234% |
| Healthcare Highways [2210] | $68 | 234% |
| Department Of Corrections [1340] | $84 | 289% |
| National Association Of Letter Carriers [1695] | $97 | 334% |
| Cigna | $97 | 334% |
| Healthpartners [1500] | $97 | 334% |
| American Postal Workers Union [1070] | $97 | 334% |
| Humana | $99 | 341% |
| First Health [1375] | $130 | 447% |
| American Healthcare [1055] | $130 | 447% |
| Multiplan [1680] | $130 | 447% |
| Administrative Concepts [1005] | $130 | 447% |
| Coventry Healthcare [1320] | $137 | 471% |
| Ks Disability Determination [6090] | $167 | 575% |
Consumer Guidance & Cost Commentary
For the Physical therapy (therapeutic exercise) service (CPT 97110) at the University Of Kansas Health System - St Francis Campus in Topeka, KS, the facility's negotiated rates are consistently $68.00 across the majority of commercial payers, including Blue Cross Blue Shield, Aetna, and Humana. This negotiated amount is significantly lower than the facility's gross charge of $167.00 and aligns closely with the state-wide average for this procedure. While the facility offers a cash median price of $50.00, which is lower than the negotiated rate, patients with high-deductible plans should be aware that paying out-of-pocket might not always be the most cost-effective option if their insurance allows for a higher allowed amount. It is crucial to verify the specific "self-pay" or "prompt-pay" discounts available before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing fees.
When evaluating costs, it is important to compare these rates against the Medicare benchmark, which stands at $29.06 for this code. The facility's negotiated rate of $68.00 represents a markup of 2.3 times the Medicare amount, which falls within the typical range for commercial pricing where rates often average 200% to 300% of Medicare. Patients should avoid assuming that being in-network guarantees the lowest possible price, as different insurers negotiate different ceilings, and some facilities may charge significantly more than others. To ensure you are receiving fair pricing, request a detailed, itemized billing audit to identify any errors or unbundled