Physical therapy (therapeutic exercise)
Facility: Lindsborg Community Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $65
- Cash Discount Price: $69
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Coventry Mcr Adv | $31 - $64 | 107% |
| Tricare | $31 - $64 | 107% |
| Blue Cross Blue Shield | $49 | 169% |
| Cigna | $55 - $115 | 189% |
| UnitedHealthcare | $58 - $122 | 200% |
| Coventry Comm-All Other Plans | $58 - $122 | 200% |
| Phcs Preferred-All Plans | $60 - $126 | 206% |
| Multiplan-All Plans | $60 - $126 | 206% |
| Health Partners -All Plans | $62 - $128 | 213% |
| Wppa-All Plans | $62 - $128 | 213% |
| Century Health-All Plans | $62 - $128 | 213% |
| Coventry Wc | $62 - $128 | 213% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), Lindsborg Community Hospital in Kansas lists a gross charge of $98.00. When comparing this to the state of Kansas, the facility's cash median rate of $69.00 is notably higher than the state average of $66.00. While the hospital offers a negotiated rate of $65.00 for in-network patients, this amount remains above the state average. It is important to note that cash payments can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rates exceed the cash price, though in this specific instance, the cash rate is higher than the state average.
Patients should be aware that commercial insurance carriers often pay significantly more than the cash price due to administrative overhead and contract dynamics. For this service, the Medicare benchmark rate is $29.06, which serves as the objective baseline for evaluating pricing markups. Commercial negotiated rates in this dataset range from $31 to $128 across various payers, with the highest negotiated amounts reaching $128 for plans like Phcs Preferred and Multiplan. To minimize out-of-pocket costs, patients are encouraged to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% when paid upfront. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their network status before scheduling to avoid unexpected charges.