Physical therapy (therapeutic exercise)
Facility: Nemaha Valley Community Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $57
- Cash Discount Price: $100
- vs. Medicare Baseline: 1.96x 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 |
|---|---|---|
| Va Ccn - All Plans | $49 | 169% |
| Humana | $49 | 169% |
| Aetna | $49 - $94 | 169% |
| Celtic Comm Exch - All Plans | $54 | 186% |
| Blue Cross Blue Shield | $57 | 196% |
| Partners Direct Health - All Plans | $58 | 200% |
| Multiplan - All Plans | $100 | 344% |
| Health Partners - All Plans | $105 | 361% |
| Midlands Choice - All Plans | $105 | 361% |
Consumer Guidance & Cost Commentary
For CPT code 97110, Physical therapy (therapeutic exercise), Nemaha Valley Community Hospital in Seneca, KS, lists a cash median price of $100.00, which is notably higher than the state average of $58.00. While the facility's negotiated rates with major payers like Aetna and Multiplan range from $49 to $105, patients with high-deductible plans may find the cash price more advantageous if their insurance negotiated rate exceeds $100.00. To ensure you are receiving the best possible rate, it is essential to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between carriers.
This service is provided by a Critical Access Hospital, a facility type often subject to specific federal pricing regulations that can influence billing structures. When reviewing your final invoice, always request a full itemized bill rather than accepting a summary statement, as hospitals may obscure individual charges for services not rendered or unbundled components. Additionally, if you choose to pay out-of-pocket, ask about prompt-pay discounts, which can reduce the total cost by 20% to 50% for upfront payments, effectively bypassing the administrative overhead associated with insurance claims processing.