Physical therapy (therapeutic exercise)
Facility: Republic County Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $73
- Cash Discount Price: $59
- vs. Medicare Baseline: 2.51x 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 251% of the Medicare baseline (a markup of 151%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $67 | 231% |
| Aetna | $71 | 244% |
| Meritain-All Plans | $71 | 244% |
| UnitedHealthcare | $73 | 251% |
| Cigna | $75 | 258% |
| Midlands Choice-All Plans | $75 | 258% |
| First Health-All Plans | $75 | 258% |
Consumer Guidance & Cost Commentary
For CPT code 97110, Physical therapy (therapeutic exercise), Republic County Hospital in Belleville, KS, has a cash median price of $59.00, which is lower than the state average of $73.00. While the facility's negotiated rates with major payers like Aetna, Cigna, and UnitedHealthcare are all set at $75.00, the cash price remains the most affordable option for patients without insurance. This pricing structure highlights a common billing dynamic where commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures; in this case, paying out-of-pocket directly could save a patient $16.00 compared to the standard negotiated rate.
Patients should verify if their specific insurance plan qualifies for a prompt-pay discount, which can reduce the bill by 20% to 50% if settled upfront, effectively lowering the cost even further than the cash median. It is important to request an itemized bill before payment to ensure no unbundled charges or services not rendered are included, as summary bills often obscure individual line items. Additionally, while the facility is a Critical Access Hospital with a voluntary non-profit ownership, the $73.00 median paid amount aligns closely with the median negotiated rate of $73.00, suggesting consistent pricing across the seven payer plans listed. Always confirm your deductible status and ask for self-pay rates prior to scheduling to avoid unexpected balance billing or higher out-of-pocket costs.