Physical therapy (therapeutic exercise)
Facility: Menorah Medical Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $48
- Cash Discount Price: $230
- vs. Medicare Baseline: 1.65x 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 |
|---|---|---|
| Humana | $24 - $61 | 83% |
| Blue Cross Blue Shield | $24 - $107 | 83% |
| Devoted Health | $24 - $28 | 83% |
| United | $24 - $107 | 83% |
| Coventry | $24 - $95 | 83% |
| Celtic | $25 - $28 | 86% |
| Cigna | $25 - $189 | 86% |
| Wellcare | $25 - $28 | 86% |
| Pyramid Life | $26 - $30 | 89% |
| Home State Health Plan | $27 | 93% |
| Triwest Health Alliance | $27 | 93% |
| Amerigroup | $28 | 96% |
| Aetna | $29 - $121 | 100% |
| Medicaid / KanCare | $29 | 100% |
| Healthyblue | $29 | 100% |
| Unicare | $29 | 100% |
| Multiplan | $33 - $175 | 114% |
| Corvel Corporation | $39 - $154 | 134% |
| Oha Network | $41 - $118 | 141% |
| Ambetter / Centene | $42 - $44 | 145% |
| Oscar | $42 - $45 | 145% |
| Nhc Advantage | $42 - $45 | 145% |
| Wppa Providrs Care Network | $45 - $47 | 155% |
| Universal Healthcare | $78 - $83 | 268% |
| Coventry Kc Mo | $92 - $97 | 317% |
| College Park Family Care Center | $96 - $102 | 330% |
| Cco, Inc. | $168 - $178 | 578% |
| Focus Healthcare Mgmt, Inc | $168 - $178 | 578% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Menorah Medical Center in Overland Park, KS, the cash price is $230.00, which matches the facility's cash median. While the facility's negotiated rates with insurance payers range from $24 to $178, these amounts are often higher than the cash price due to administrative costs and contract structures. It is important to note that commercial rates can sometimes exceed cash prices; for instance, Cigna's negotiated range extends up to $189, meaning patients with high-deductible plans might save money by paying the cash rate of $230.00 directly rather than relying on insurance reimbursement. Additionally, patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as paying upfront can sometimes reduce the final amount owed.
When evaluating the cost of this service, it is crucial to compare rates against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare amount for this procedure is $29.06, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often average between 200% and 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150% of Medicare. In this case, the cash price of $230.00 represents approximately 790% of the Medicare rate, indicating a significant markup. Patients should also be aware of balance billing risks if they receive out-of-network care, though the No Surprises Act protects against such billing for emergency and non-emergency services at in-network facilities. Finally, if a large bill is received