Physical therapy (therapeutic exercise)
Facility: Kiowa County Memorial Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $69
- Cash Discount Price: $66
- vs. Medicare Baseline: 2.37x 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 237% of the Medicare baseline (a markup of 137%). 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 | $49 - $69 | 169% |
| UnitedHealthcare | $62 - $78 | 213% |
| Medica Prime Mcare Cost-All Plans | $69 | 237% |
| Health Partners Of Ks-All Plans | $69 | 237% |
| Celtic Comml Exchange-All Other Plans | $69 | 237% |
| Humana | $69 | 237% |
| Aetna | $69 | 237% |
| Medicaid / KanCare | $78 | 268% |
| Providrs Care/Wppa-All Plans | $117 | 403% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), Kiowa County Memorial Hospital in Greensburg, KS, lists a cash median price of $66.00 and a median negotiated rate of $69.00. This cash price is notably lower than the facility's gross charge of $78.00 and significantly below the Medicare benchmark of $29.06 when adjusted for the facility's specific cost structure, though the direct comparison shows the cash rate exceeds the base Medicare amount. Patients with high-deductible plans may find paying the cash median of $66.00 more cost-effective than relying on insurance, as the negotiated rate of $69.00 often exceeds the cash price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed before any insurance claim is processed.
The facility's pricing data reflects a mix of payer contracts, with negotiated ranges for major insurers like Blue Cross Blue Shield ($49–$69) and UnitedHealthcare ($62–$78), while Medicaid/KanCare and Medicaid/All Plans show a fixed rate of $69.00. Because this service is provided at a Critical Access Hospital, federal protections under the No Surprises Act may apply if out-of-network providers are involved, preventing balance billing for emergency or non-emergency services at in-network facilities. Consumers should avoid accepting summary bills that obscure individual line items; instead, requesting a full itemized audit is the most effective way to identify errors, unbundled codes, or services not rendered. By comparing the facility's rates against