Physical therapy (therapeutic exercise)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $28
- Cash Discount Price: $54
- vs. Medicare Baseline: 0.96x 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.
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 | $27 | 93% |
| Blue Cross Blue Shield | $28 | 96% |
| Providrs Care Network | $28 | 96% |
| Aetna | $28 - $34 | 96% |
| United Mine Workers Of America | $28 | 96% |
| UnitedHealthcare | $28 - $33 | 96% |
| Lantern Specialty Care | $44 | 151% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), the Kansas Spine & Specialty Hospital, Llc in Wichita, KS, lists a gross charge of $83.00. While the facility's cash median rate is $54.00 and the median negotiated rate across payers is $28.00, the Medicare benchmark for this service is $29.06. This indicates that the facility's cash price is nearly double the Medicare rate, suggesting a significant markup compared to the federal baseline. Commercial negotiated rates vary by insurer, ranging from $27.00 to $44.00, with Aetna showing the widest spread between its low and high plan rates ($28.00 to $34.00). Patients should be aware that while insurance often results in lower out-of-pocket costs, the cash price of $54.00 may still be more affordable than the final allowed amount if a patient has a high deductible or is self-paying, as the negotiated rate includes administrative overheads that do not apply to direct cash payments.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% and bypass costly insurance claim processing. It is critical to avoid automatic claims submission, which can void cash agreements and lead to higher charges; signing a waiver of insurance submission at registration is the most effective way to secure the lowest possible rate. Additionally, patients should demand a full itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain