Physical therapy (therapeutic exercise)
Facility: Centura St. Catherine-Dodge City
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $115
- Cash Discount Price: $70
- vs. Medicare Baseline: 3.96x 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 396% of the Medicare baseline (a markup of 296%). 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 |
|---|---|---|
| Cigna | $30 | 103% |
| Aetna | $30 - $139 | 103% |
| Kaiser | $30 | 103% |
| Blue Cross Blue Shield | $30 - $67 | 103% |
| Humana | $30 | 103% |
| Kansas Health | $30 | 103% |
| Medicare (plans) | $30 | 103% |
| Centura Employee Plan | $72 | 248% |
| UnitedHealthcare | $115 | 396% |
| Wpaa | $122 | 420% |
| Multiplan | $139 - $157 | 478% |
| Christian Health Aid | $139 | 478% |
| Health Partners Of Kansas | $157 | 540% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Centura St. Catherine-Dodge City, the cash median price is $70.00, which is significantly lower than the facility's negotiated rates ranging from $30 to $157 depending on the insurance plan. While many commercial payers like Aetna and Multiplan have negotiated rates exceeding the cash price, Medicare sets a benchmark of $29.06, indicating that the cash rate of $70.00 is approximately 4.0 times the Medicare amount. Patients with high-deductible plans may find it financially advantageous to pay the $70.00 cash price directly, as this avoids the administrative overhead and potential higher negotiated rates charged to insured members. It is important to note that while the facility offers a cash median of $70.00, the actual self-pay or prompt-pay discount could be lower if requested upfront before scheduling, as hospitals often provide fee reductions for immediate payment to bypass costly claims processing.
The facility's negotiated rates vary widely across the 13 payers listed, with the lowest commercial rate being $30.00 for Cigna and the highest reaching $157.00 for Health Partners Of Kansas. This variation highlights that being in-network does not guarantee the lowest possible price, as some commercial contracts are structured higher than the cash alternative. To ensure you are not overpaying, you should verify your specific plan's allowed amount before the visit and ask the billing department about any prompt-pay discounts available for self-pay patients. Additionally, if you receive a bill that includes charges beyond the negotiated rate, such as out-of-network ancillary services, you have the right to dispute balance billing under the No