Physical therapy (therapeutic exercise)
Facility: Minneola District Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $63
- Cash Discount Price: $49
- 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 |
|---|---|---|
| Va Community Care Program-All Plans | $47 | 162% |
| UnitedHealthcare | $47 - $70 | 162% |
| Humana | $47 | 162% |
| Blue Cross Blue Shield | $49 | 169% |
| Corporate Plan Management-All Plans | $60 | 206% |
| Providrs Care Network-All Plans | $60 | 206% |
| Triwest-All Plans | $63 | 217% |
| Preferred Health Care (Coventry)-All Other Plans | $63 | 217% |
| Health Partners Of Kansas-All Plans | $66 | 227% |
| Aetna | $66 - $70 | 227% |
| Phc (Coventry) Leased Network | $66 | 227% |
| Medicaid / KanCare | $70 | 241% |
Consumer Guidance & Cost Commentary
For the CPT code 97110 (Physical therapy), Minneola District Hospital lists a cash median of $49.00, which is lower than the state average of $63.00. However, patients with high-deductible plans should note that insurance negotiated rates often exceed cash prices; for instance, UnitedHealthcare's negotiated range spans $47 to $70, while Medicaid/KanCare pays exactly $70. Because commercial payers frequently charge more than the cash rate due to administrative overhead and contract structures, paying out-of-pocket upfront can sometimes result in lower total costs compared to using insurance, provided the patient's deductible has been met.
The facility's gross charge is $70.00, which serves as the baseline before any discounts or insurance adjustments. To minimize potential balance billing or unexpected fees, patients should verify their specific plan's allowed amount before scheduling, as some in-network rates may approach the gross charge. Additionally, since hospitals often offer prompt-pay discounts for upfront cash payments, it is advisable to contact the billing department directly to confirm if a self-pay discount is available, which could further reduce the final amount owed below the listed cash median.