Physical therapy (therapeutic exercise)
Facility: Phillips County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $63
- Cash Discount Price: $56
- vs. Medicare Baseline: 2.17x 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 217% of the Medicare baseline (a markup of 117%). 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 |
|---|---|---|
| UnitedHealthcare | $50 - $68 | 172% |
| Blue Cross Blue Shield | $51 - $57 | 175% |
| Medicaid / KanCare | $63 - $68 | 217% |
| Health Partners-All Plans | $63 - $68 | 217% |
Consumer Guidance & Cost Commentary
For CPT code 97110, Physical therapy (therapeutic exercise), Phillips County Hospital in Phillipsburg, KS, lists a cash median price of $56.00, which is lower than the state average of $55.00 and significantly below the facility's gross charge of $66.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find that paying cash upfront is more cost-effective than using insurance, as the negotiated rates for in-network payers like UnitedHealthcare and Blue Cross Blue Shield range from $50.00 to $68.00. Because commercial insurance contracts often include administrative overheads that inflate the baseline price, the cash price can sometimes represent the truest measure of value for services not covered by a deductible.
To avoid unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the costly insurance billing cycle. It is also important to understand that while the No Surprises Act protects patients from balance billing for emergency care at in-network facilities, unexpected charges can still occur if ancillary services like labs are out-of-network. If you receive a bill, always request a full itemized CPT-coded statement rather than accepting a summary invoice, and dispute any errors in writing to ensure you are only paying for services actually rendered.