Physical therapy (therapeutic exercise)
Facility: Pratt Regional Medical Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $108
- Cash Discount Price: $89
- vs. Medicare Baseline: 3.72x 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 372% of the Medicare baseline (a markup of 272%). 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 |
|---|---|---|
| Celtic Insurance Company | $28 | 96% |
| Healthy Blue | $29 | 100% |
| UnitedHealthcare | $31 - $130 | 107% |
| Christian Health Aid | $95 | 327% |
| Health Partners Of Kansas | $107 - $108 | 368% |
| Aetna | $113 - $114 | 389% |
| Choicecare | $126 - $127 | 434% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), Pratt Regional Medical Center in Pratt, KS, has a cash median price of $89.00, which is lower than the facility's negotiated rate of $108.00. While the facility's gross charge is $127.00, patients should be aware that commercial insurance negotiated rates vary significantly by carrier, ranging from $28.00 with Celtic Insurance Company to $130.00 with UnitedHealthcare. This variation highlights that being "in-network" does not guarantee the lowest possible price, as some payers may negotiate rates higher than the cash-pay option. For patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $89.00 upfront could result in immediate savings compared to the higher negotiated rates charged by many commercial insurers.
To ensure you are receiving the most accurate and transparent pricing, it is recommended to request an itemized bill before finalizing payment, as summary bills often obscure individual code costs and potential errors. Additionally, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final amount owed by 20% to 50% if paid in full within a short window. When evaluating the facility's pricing against national standards, the Medicare amount for this service is $29.06, and the facility's pricing is 3.7 times the Medicare rate. While the facility is a Proprietary Acute Care Hospital with a 4-star rating, consumers should verify their specific plan details and deductible status to determine if