Physical therapy (therapeutic exercise)
Facility: Sheridan County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $78
- Cash Discount Price: $99
- vs. Medicare Baseline: 2.68x 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 268% of the Medicare baseline (a markup of 168%). 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 Insurance | $59 - $60 | 203% |
| Blue Cross Blue Shield | $78 | 268% |
| UnitedHealthcare | $93 - $95 | 320% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), Sheridan County Hospital in Hoxie, KS, lists a cash price of $99.00. This cash rate is significantly higher than the state average, which is $29.06 (the Medicare benchmark). While the facility offers a negotiated rate of $78.00 to in-network payers like Celtic Insurance and Blue Cross Blue Shield, these amounts often exceed the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find paying the full $99.00 upfront more cost-effective than relying on insurance, especially if their deductible has not yet been met or if the insurer's negotiated rate is higher than the cash charge.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Additionally, you should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the costly insurance claims cycle. If you receive a surprise balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full charge and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Always dispute any unexpected charges in writing rather than accepting summary bills or verbal assurances.