Physical therapy (therapeutic exercise)
Facility: Kansas City Orthopaedic Institute
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $102
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.51x 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 351% of the Medicare baseline (a markup of 251%). 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 |
|---|---|---|
| UnitedHealthcare | $37 - $124 | 127% |
| Aetna | $37 | 127% |
| Cigna | $37 - $125 | 127% |
| Blue Cross Blue Shield | $76 - $112 | 262% |
| Medica | $172 | 592% |
Consumer Guidance & Cost Commentary
For the Physical therapy (therapeutic exercise) service at Kansas City Orthopaedic Institute, the negotiated payment rates range from $37 to $172 depending on your specific insurance plan. While the facility's negotiated rates are generally higher than the Medicare benchmark of $29.06, which serves as a reliable cost baseline, patients with high-deductible plans may find that paying the cash price directly is more economical. Although the cash median is not listed for this service, the data indicates that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. To maximize savings, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can significantly reduce the final amount owed if you choose to pay upfront.
This service is billed under CPT code 97110, and the facility is located in Leawood, KS. The data provided does not include specific cash or median paid figures for this procedure, so direct comparisons to state or county averages cannot be made from the available information. However, understanding the difference between the gross chargemaster price of $134.00 and the actual negotiated amounts paid by insurers like UnitedHealthcare ($37–$124) or Blue Cross Blue Shield ($76–$112) is crucial for budgeting. If you receive a bill that appears to be a summary invoice rather than a detailed itemized statement, you should request a full line-by-line audit to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.