Physical therapy (therapeutic exercise)
Facility: Wichita County Health Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $65
- Cash Discount Price: $57
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Medicaid / KanCare | $54 - $64 | 186% |
| UnitedHealthcare | $65 - $78 | 224% |
Consumer Guidance & Cost Commentary
For Physical therapy (therapeutic exercise) at Wichita County Health Center in Leoti, KS, the cash price of $57.00 is lower than the facility's median negotiated rate of $65.00, which aligns closely with the state average of $59.00. While Medicaid and UnitedHealthcare plans negotiate rates ranging from $54 to $78, patients with high-deductible plans might find paying cash directly more cost-effective if their insurance allowed amount exceeds the cash price. It is important to note that commercial negotiated rates often include administrative overhead and contract premiums, making them higher than the cash price even though they protect in-network members from the full chargemaster gross.
To maximize savings, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the costly insurance billing cycle and administrative labor. Since over 80% of hospital bills contain errors, consumers are encouraged to request a full itemized CPT-coded statement rather than accepting a summary bill, ensuring no charges for services not rendered or unbundled components are included. By comparing the Medicare benchmark of $29.06 against the facility's rates, you can see that the cash price represents a fair market value, whereas the commercial negotiated rates reflect the standard markup found in the healthcare system.