Physical therapy (therapeutic exercise)
Facility: Overland Park Reg Med Ctr
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $66
- Cash Discount Price: $349
- vs. Medicare Baseline: 2.27x 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 227% of the Medicare baseline (a markup of 127%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $24 - $151 | 83% |
| Humana | $24 - $61 | 83% |
| Devoted Health | $24 - $28 | 83% |
| United | $24 - $158 | 83% |
| Coventry | $24 - $141 | 83% |
| Wellcare | $25 - $28 | 86% |
| Celtic | $25 - $28 | 86% |
| Cigna | $25 - $28 | 86% |
| Pyramid Life | $26 - $30 | 89% |
| Home State Health Plan | $27 | 93% |
| Triwest Health Alliance | $27 | 93% |
| Amerigroup | $28 | 96% |
| Aetna | $29 - $179 | 100% |
| Healthyblue | $29 | 100% |
| Unicare | $29 | 100% |
| Medicaid / KanCare | $29 | 100% |
| Multiplan | $33 - $260 | 114% |
| Corvel Corporation | $39 - $228 | 134% |
| Oha Network | $41 - $176 | 141% |
| Ambetter / Centene | $64 - $65 | 220% |
| Nhc Advantage | $66 - $67 | 227% |
| Oscar | $66 - $67 | 227% |
| Wppa Providrs Care Network | $69 - $70 | 237% |
| Universal Healthcare | $121 - $123 | 416% |
| Coventry Kc Mo | $142 - $144 | 489% |
| College Park Family Care Center | $149 - $151 | 513% |
| Focus Healthcare Mgmt, Inc | $259 - $264 | 891% |
| Cco, Inc. | $259 - $264 | 891% |
Consumer Guidance & Cost Commentary
For the CPT code 97110 (Physical therapy), the Overland Park Reg Med Ctr lists a cash price of $349.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $29.06, reflecting a markup of 2.3 times the federal standard. While the facility's negotiated rates for in-network payers generally range from $24 to $264, the data indicates that some commercial plans, such as Multiplan and Corvel Corporation, have negotiated rates exceeding $300, which can surpass the cash price. Patients with high-deductible plans should verify whether their specific plan's negotiated rate is lower than the cash amount, as paying out-of-pocket might result in lower immediate costs if the insurance allowed amount is high.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can bypass administrative fees and reduce the final bill by 20% to 50%. It is also critical to avoid balance billing by confirming that the facility is in-network for the specific service, as the No Surprises Act protects against unexpected out-of-network charges at in-network facilities. Finally, consumers should request a detailed, itemized bill rather than a summary invoice to identify any errors or unbundled codes, ensuring that the final charge aligns with the negotiated or cash rates provided.