Physical therapy (therapeutic exercise)
Facility: Mcpherson Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $83
- Cash Discount Price: $81
- vs. Medicare Baseline: 2.86x 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 286% of the Medicare baseline (a markup of 186%). 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 |
|---|---|---|
| Tricare | $24 | 83% |
| UnitedHealthcare | $28 - $109 | 96% |
| Va Ccn - All Plans | $28 | 96% |
| Humana | $28 | 96% |
| Healthy Blue Mcr Adv | $28 | 96% |
| Blue Cross Blue Shield | $28 | 96% |
| Wellcare Mcr Adv - All Plans | $28 | 96% |
| Ambetter / Centene | $32 | 110% |
| Wppa - All Plans | $76 | 262% |
| Central Plains - All Plans | $82 | 282% |
| Medical Associates - All Plans | $82 | 282% |
| Christian Health Aid - All Plans | $87 | 299% |
| Aetna | $90 - $109 | 310% |
| Multiplan - All Plans | $98 | 337% |
| Health Partners - All Plans | $104 | 358% |
| Cigna | $104 | 358% |
| First Health - All Plans | $104 | 358% |
| Medicaid / KanCare | $109 | 375% |
| Health Blue Mcaid - All Other Plans | $111 | 382% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services at McPherson Hospital in Mcpherson, Kansas, the facility's cash price of $81.00 is notably lower than the state average of $82.00 and the median negotiated rate of $83.00. While many commercial payers, such as UnitedHealthcare and Aetna, negotiate rates ranging from $28 to $109, the cash price offers a distinct advantage for patients with high-deductible plans who may not yet have met their coverage thresholds. In these scenarios, paying the cash price directly can result in immediate savings compared to the higher negotiated rates that insurance carriers pay, which often include administrative overheads that inflate the baseline cost by 20% to 40%.
To maximize cost savings, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can further reduce the final bill by bypassing the costly claims processing cycle. It is also important to note that while the facility is an in-network location for many insurers, the No Surprises Act protects consumers from balance billing for out-of-network services at in-network facilities, though patients should still review their itemized bills to ensure no unbundled codes or services not rendered have been incorrectly charged. Ultimately, comparing the facility's cash rate against the Medicare benchmark of $29.06 reveals that the commercial negotiated rates, while higher, are generally aligned with fair pricing standards rather than the inflated chargemaster lists often used to mislead patients about their potential savings.