CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Kansas Medical Center Llc

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $28
  • Cash Discount Price: $47
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Kansas Medical Center Llc is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $47. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in 1124 West 21St Street, Andover, KS.
Cash / Self-Pay
$47

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $47 (162%)
Insurance Median: $28 (96%)
Cash: $47 (162% of Medicare)
Ins. Median: $28 (96% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Tricare $25 86%
Indian Health $25 86%
Ambetter / Centene $28 96%
Medicaid / KanCare $28 96%
Humana $28 96%
Medadv_Wellcare $28 96%
Blue Cross Blue Shield $28 - $54 96%
Wppa $31 107%
Three_Rivers $55 189%
Aetna $62 213%
United $78 268%

Consumer Guidance & Cost Commentary

For this physical therapy session at Kansas Medical Center Llc in Andover, the cash price is $47.00, which is lower than the facility's negotiated rates with most major payers. While the facility's cash rate is below the state average of $52.00, patients with high-deductible plans may find paying out-of-pocket or using a prompt-pay discount more cost-effective than relying on insurance, as many commercial payers negotiate rates significantly higher than the cash price. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated amount could result in a higher out-of-pocket expense if your deductible has not yet been met.

The data indicates that this facility's cash rate is also lower than the national Medicare benchmark of $29.06, suggesting a competitive pricing structure relative to federal standards. However, because the facility is an acute care hospital, patients should be aware of potential balance billing risks if they receive out-of-network services, such as certain laboratory tests or emergency physician visits, even if the primary therapy is covered. To avoid unexpected charges, patients should request a full itemized bill before paying and dispute any errors, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit. Additionally, asking for a "self-pay" or "prompt-pay" discount at registration can often reduce the final cost further, bypassing the administrative overhead associated with insurance claims processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1124 West 21St Street, Andover, KS 67002
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals