Physical therapy (therapeutic exercise)
Facility: Stevens County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $53
- Cash Discount Price: $65
- vs. Medicare Baseline: 1.82x 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 |
|---|---|---|
| Aetna | $20 - $77 | 69% |
| Humana | $20 - $28 | 69% |
| First Health - All Plans | $48 - $69 | 165% |
| Wppa - All Plans | $50 - $73 | 172% |
| Medicaid / KanCare | $53 - $77 | 182% |
| Blue Cross Blue Shield | $54 - $57 | 186% |
Consumer Guidance & Cost Commentary
For this Physical therapy (therapeutic exercise) service at Stevens County Hospital in Hugoton, KS, the cash price is $65.00, which matches the facility's cash median. While the facility's negotiated rates with major payers like Aetna, Humana, and Medicaid range from $20 to $77, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the $65.00 cash rate more cost-effective than relying on insurance, as the negotiated allowed amounts frequently exceed the cash price. To secure the lowest possible rate, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront.
When evaluating the cost of this service, it is important to compare the cash price against the Medicare benchmark rather than the hospital's full chargemaster list. The Medicare rate for this code is $29.06, and commercial negotiated rates typically average 200% to 300% of this amount, whereas fair pricing is often defined as 120% to 150%. By comparing the $65.00 cash price to the Medicare rate, patients can see that the cash price represents a significant markup over the federal baseline. Additionally, since over 80% of hospital bills contain errors, patients should request a detailed, itemized statement before paying to ensure no unbundled codes or services not rendered are included in the final charge.