Physical therapy (therapeutic exercise)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $43
- Cash Discount Price: $62
- vs. Medicare Baseline: 1.48x 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 |
|---|---|---|
| Aetna | $29 - $50 | 100% |
| UnitedHealthcare | $35 | 120% |
| Blue Cross Blue Shield | $57 | 196% |
Consumer Guidance & Cost Commentary
For Physical therapy (therapeutic exercise) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $62.00, which matches the facility's negotiated rate for UnitedHealthcare. This cash price is significantly higher than the Medicare benchmark of $29.06, reflecting a markup of 1.5 times the federal rate. While the facility's negotiated rates for Aetna ($29–$50) and Blue Cross Blue Shield ($57) vary, patients with high-deductible plans may find paying the $62.00 cash price more cost-effective if their insurance negotiated rates exceed this amount. Given that the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, it is advisable to contact the billing department directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling services.
To ensure you are not overcharged, always request a full itemized bill rather than accepting a summary invoice, as hospitals often use broad categories to obscure individual code costs. If you receive a bill, verify that no services were unbundled or that charges exist for items never rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute. Furthermore, remember that while the facility is in-network for several payers, the No Surprises Act protects you from balance billing for out-of-network services at this in-network Critical Access Hospital, though you should still verify your deductible status before using insurance to avoid unexpected out-of-pocket costs.