CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Greenwood County Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $53
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 1.82x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Greenwood County Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.82x the Medicare baseline. Located in 100 W 16Th Street, Eureka, KS.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $50 (172%)
Insurance Median: $53 (182%)
Cash: $50 (172% of Medicare)
Ins. Median: $53 (182% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Triwest - All Plans $22 76%
Choicecare Mcr Adv - All Plans $26 89%
UnitedHealthcare $26 - $53 89%
Tricare $26 89%
Integrated Health Plan - All Plans $47 162%
Blue Cross Blue Shield $47 - $49 162%
Beech Street - All Plans $54 186%
First Health - All Other Plans $54 186%
First Health Ccn Network $54 186%
Preferred Hs (Coventry) - All Plans $57 196%
Principal Health Care Inc - All Plans $60 206%
Amerigroup Mcaid-All Plans $63 217%
Medicaid / KanCare $63 217%
Providrs Care/Wppa - All Plans $94 323%

Consumer Guidance & Cost Commentary

For the CPT code 97110 (Physical therapy), Greenwood County Hospital in Eureka, KS, has a gross charge of $63.00. The facility's cash median rate is $50.00, which is lower than the negotiated rates paid by most commercial payers, such as UnitedHealthcare and Blue Cross Blue Shield, which range from $26.00 to $53.00. While the facility is a Critical Access Hospital with government local ownership, patients should note that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the negotiated rate might exceed the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can significantly reduce the final amount owed.

The facility's negotiated rates vary widely across different insurance plans, with the lowest allowed amount being $22.00 from Triwest and the highest at $94.00 from Providrs Care/Wppa. For context, the Medicare amount for this service is $29.06, which serves as a benchmark for fair pricing; commercial negotiated rates often exceed this baseline due to administrative costs and contract structures. Since the data does not provide specific state or county average comparisons for this exact code, patients are encouraged to verify their specific plan's allowed amount prior to treatment. To avoid unexpected costs, individuals should request an itemized bill to review all charges and ensure no services were unbundled or duplicated, as over 80% of hospital bills contain errors that can be corrected through a formal audit.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 W 16Th Street, Eureka, KS 67045
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals