Physical therapy (therapeutic exercise)
Facility: Wesley Medical Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $38
- Cash Discount Price: $517
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Devoted Health | $24 - $28 | 83% |
| Aetna | $24 - $200 | 83% |
| Coventry Health Care | $24 - $28 | 83% |
| Humana | $24 - $28 | 83% |
| United | $25 - $233 | 86% |
| Ambetter / Centene | $25 - $93 | 86% |
| Triwest Health Alliance | $27 | 93% |
| UnitedHealthcare | $28 | 96% |
| Amerigroup | $29 | 100% |
| Medicaid / KanCare | $29 | 100% |
| Correct Care Solutions | $36 - $41 | 124% |
| First Health | $39 - $238 | 134% |
| Multiplan | $41 - $465 | 141% |
| Blue Cross Blue Shield | $57 | 196% |
| Health Partners Of Kansas | $89 - $258 | 306% |
| Wppa | $90 | 310% |
| Medical Associates Health Plan | $98 | 337% |
| Preferred Health Choices | $98 | 337% |
| Spirit Aerosystems | $165 | 568% |
| Triwest Healthcare Alliance | $336 | 1156% |
| Usa Managed Care | $439 | 1511% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), the cash price at Wesley Medical Center in Wichita, KS, is $517.00. This cash rate aligns exactly with the cash median for the facility. When compared to the national benchmark, this cash price is 130% of the Medicare amount of $29.06. While commercial insurance plans offer negotiated rates ranging from $24 to $465, many of these in-network rates exceed the cash price. For patients with high-deductible plans, paying the cash rate of $517.00 upfront may result in lower out-of-pocket costs than the insurance negotiated rate, provided the patient has not yet met their deductible. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final amount owed.
The facility's pricing structure reflects a proprietary ownership model with 21 different payers, including major carriers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield. While the facility's cash rate is competitive relative to the national average, patients should be aware that commercial negotiated rates can vary significantly, with some plans paying as high as $465 for this service. To ensure you are receiving the most accurate pricing, always request an itemized bill before finalizing payment. This allows you to verify that charges are correctly bundled and that no services not rendered have been included. If you receive a summary bill, you have the right to demand a detailed breakdown to identify any errors or unbundled codes that could be disputed.