Physical therapy (therapeutic exercise)
Facility: Logan County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $81
- Cash Discount Price: $22
- vs. Medicare Baseline: 2.79x 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 279% of the Medicare baseline (a markup of 179%). 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 |
|---|---|---|
| Humana | $47 | 162% |
| Blue Cross Blue Shield | $57 | 196% |
| Health Partners - All Plans | $104 | 358% |
| Medicaid / KanCare | $110 | 379% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Logan County Hospital in Oakley, KS, the negotiated rates for major payers like Humana and Blue Cross Blue Shield range from $47 to $110, which is significantly higher than the facility's cash price of $22.00. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative fees and claim processing, patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $22.00 rate is substantially lower than the negotiated amounts. It is important to note that Medicaid/KanCare covers the full $110.00 charge, reflecting the specific contractual agreements for that program.
To ensure you are not overcharged, always request an itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you receive a balance bill for out-of-network services, you may be entitled to protections under the No Surprises Act, which prevents providers from charging you the difference between their full rate and your insurance allowed amount. Additionally, ask the hospital about prompt-pay discounts, which can reduce your cash bill by 20% to 50% if paid upfront, bypassing the costly insurance billing cycle.