Physical therapy (therapeutic exercise)
Facility: Grisell Memorial Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $77
- Cash Discount Price: $84
- vs. Medicare Baseline: 2.65x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 265% of the Medicare baseline (a markup of 165%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $47 | 162% |
| UnitedHealthcare | $66 - $89 | 227% |
| Medicaid / KanCare | $89 | 306% |
| Humana | $89 | 306% |
Consumer Guidance & Cost Commentary
For this Physical therapy (therapeutic exercise) service at Grisell Memorial Hospital in Ransom, KS, the facility's cash median rate of $84.00 is lower than the negotiated rates paid by major insurers like UnitedHealthcare ($66.00 to $89.00) and Blue Cross Blue Shield ($47.00 to $47.00). While the hospital is a Critical Access Hospital owned by a Government Hospital District, patients with high-deductible plans may find the cash price more affordable than their insurance allowed amount, which could exceed the cash rate depending on their specific plan. It is important to note that while the facility offers a cash median of $84.00, the median paid amount by insurers is $89.00, and the median negotiated rate is $77.00, suggesting that direct payment might not always be the lowest option if your insurance allows a higher reimbursement.
To ensure you are not overcharged, always request a full itemized bill before paying, as summary bills often hide errors or unbundled codes that inflate the total. If you receive a balance bill for services rendered at an in-network facility, you may be protected under the No Surprises Act, which bans balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. Additionally, since the facility is a Critical Access Hospital, you should inquire about prompt-pay discounts, which can reduce the final cost by 20% to 50% if paid upfront, bypassing the administrative costs associated with insurance claims processing. Always verify your deductible status and ask for self-pay rates prior to scheduling to avoid unexpected charges.