Physical therapy (therapeutic exercise)
Facility: Kansas Surgery & Recovery Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $48
- Cash Discount Price: $70
- 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 |
|---|---|---|
| Blue Cross Blue Shield | $27 - $37 | 93% |
| Aetna | $27 - $48 | 93% |
| UnitedHealthcare | $27 - $82 | 93% |
| Cigna | $59 - $82 | 203% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), the Kansas Surgery & Recovery Center lists a cash price of $71.00, which is notably higher than the state average cash median of $70.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield, Aetna, UnitedHealthcare, and Cigna range from $27 to $82, these amounts often exceed the cash price due to administrative overhead and contract structures. It is important to note that for patients with high-deductible plans, paying the cash price of $71.00 upfront can sometimes result in lower out-of-pocket costs compared to the negotiated rates their insurance would allow, provided they have not yet met their deductible.
To maximize savings, patients should verify if the facility offers "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid in full before services are rendered. Additionally, while the Medicare benchmark for this service is $29.06, commercial rates frequently average 200% to 300% of this baseline; however, fair pricing is typically defined as 120% to 150% of the Medicare amount. Before scheduling, it is advisable to request an itemized billing audit to ensure no errors, double-billing, or unbundled codes are present, as over 80% of hospital bills contain discrepancies that can be corrected through a formal written dispute.