Physical therapy (therapeutic exercise)
Facility: Lincoln County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $57
- Cash Discount Price: $73
- vs. Medicare Baseline: 1.96x 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.
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 | $57 | 196% |
Consumer Guidance & Cost Commentary
For this Physical therapy (therapeutic exercise) service at Lincoln County Hospital, the cash price of $73.00 is lower than the facility's negotiated rate of $57.00, which is the amount Blue Cross Blue Shield pays. While the facility is a Critical Access Hospital in Lincoln, Kansas, the data does not provide specific county or state average rates for comparison. However, it is important to note that cash-pay options can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price, as seen here where the negotiated rate is higher than the cash price. Patients should verify if the hospital offers "self-pay" or "prompt-pay" discounts before scheduling to ensure they are receiving the most favorable rate available.
The Medicare benchmark for this service is $29.06, which serves as a baseline for evaluating the facility's pricing markup. The cash price of $73.00 represents a significant increase over the Medicare amount, reflecting the administrative costs and provider fees associated with commercial billing. Since the facility is government-owned locally, patients should be aware that commercial rates often include additional layers of administrative overhead that are not present in the federal government's fixed reimbursement rates. To avoid unexpected costs, consumers should request an itemized bill to review specific CPT codes and ensure there are no errors, double-billing, or unbundled charges before finalizing payment.