Physical therapy (therapeutic exercise)
Facility: Great Plains Of Sabetha
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $67
- Cash Discount Price: $69
- vs. Medicare Baseline: 2.31x 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 231% of the Medicare baseline (a markup of 131%). 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 |
|---|---|---|
| Celtic Mcr Adv | $35 - $49 | 120% |
| Aetna | $35 - $96 | 120% |
| Celtic Comm Exchange-All Other Plans | $44 - $62 | 151% |
| Great West Healthcare-All Plans | $57 - $81 | 196% |
| UnitedHealthcare | $62 - $95 | 213% |
| Humana | $64 - $90 | 220% |
| Federated Mutual Ins-All Plans | $64 - $91 | 220% |
| Century/Wppa/Providers-All Plans | $64 - $90 | 220% |
| Multiplan-Phcs-All Plans | $64 - $90 | 220% |
| Cigna | $64 - $90 | 220% |
| Blue Cross Blue Shield | $67 - $95 | 231% |
| Medicaid / KanCare | $67 - $95 | 231% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services at Great Plains Of Sabetha in Sabetha, Kansas, the cash price is $69.00. This cash rate is notably higher than the facility's negotiated average of $67.00 and the median paid amount of $64.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if their deductible has not yet been met. In such cases, paying the cash price directly avoids the administrative overhead and potential out-of-pocket costs associated with insurance claims processing. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
When evaluating this charge, it is important to compare rates against objective benchmarks rather than the facility's inflated chargemaster list. The Medicare amount for this service is $29.06, which serves as a scientifically validated baseline for the true cost of care. Commercial negotiated rates often average between 200% and 300% of Medicare, though fair pricing is typically defined as 120% to 150% of this benchmark. For this specific code, the cash rate of $69.00 represents approximately 2.3 times the Medicare amount. Patients should avoid accepting summary bills that obscure individual line items and instead request a full itemized audit to identify any unbundled codes or services not rendered. If a balance bill arises from an out-of-network situation, the No Surprises Act may provide federal protections against unexpected charges, and patients should