Physical therapy (therapeutic exercise)
Facility: Stanton County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $110
- Cash Discount Price: $116
- vs. Medicare Baseline: 3.79x 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 379% of the Medicare baseline (a markup of 279%). 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 | $54 - $110 | 186% |
| Healthy Blue Mcr Adv - All Other Plans | $113 | 389% |
| Healthy Blue Mcaid | $116 | 399% |
Consumer Guidance & Cost Commentary
For the CPT code 97110 (Physical therapy), Stanton County Hospital in Johnson, KS, lists a cash price of $116.00, which matches the facility's negotiated rate for Healthy Blue Mcaid and the gross charge for Blue Cross Blue Shield. This cash price is notably higher than the state average of $111.00, though it aligns closely with the county average of $110.00. While the cash rate is competitive relative to local peers, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance negotiated rate exceeds this amount, as the cash price represents the lowest possible cost for this service without insurance involvement.
The facility's Medicare benchmarking rate of $29.06 provides a clear baseline for evaluating commercial pricing, as commercial negotiated rates often range from 200% to 300% of this figure. Although the data does not show a specific county or state average for the negotiated rate, the cash price of $116.00 is significantly higher than the Medicare amount, reflecting the standard markup for commercial coverage. To secure the best possible price, patients should explicitly request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing administrative claim processing costs.