Physical therapy (therapeutic exercise)
Facility: Wamego Health Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $29
- Cash Discount Price: $70
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| Medicaid / KanCare | $26 - $29 | 89% |
| UnitedHealthcare | $28 | 96% |
| Aetna | $29 | 100% |
| Providrs Care | $36 | 124% |
| Blue Cross Blue Shield | $75 - $79 | 258% |
Consumer Guidance & Cost Commentary
For the Physical therapy (therapeutic exercise) service at Wamego Health Center, the cash price is $70.00, which is significantly lower than the facility's gross charge of $176.00. While the facility is a Critical Access Hospital in Wamego, KS, and serves five payers including Medicaid/KanCare, UnitedHealthcare, and Aetna, the cash rate of $70.00 is notably higher than the state average for this procedure. Patients with high-deductible plans or those without insurance may find this cash price more affordable than their insurance negotiated rates, which range from $26 to $79 depending on the specific plan. It is important to note that while commercial negotiated rates often exceed cash prices due to administrative costs and contract structures, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not paying more than necessary.
To avoid unexpected costs, consumers should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. Additionally, if you receive a bill from an out-of-network provider or encounter charges for services not rendered, you have the right to request an itemized billing audit to identify errors such as double-billing or code unbundling, as over 80% of hospital bills contain inaccuracies. Under the No Surprises Act, you are protected from balance billing for emergency care and non-emergency services at in-network facilities, so any surprise bill should be disputed immediately with your insurer rather than paying it out of fear of credit damage. Always demand a full, line-by-line