Physical therapy (therapeutic exercise)
Facility: Hodgeman County Health Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $69
- Cash Discount Price: $78
- vs. Medicare Baseline: 2.37x 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 237% of the Medicare baseline (a markup of 137%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $47 - $49 | 162% |
| Medicaid / KanCare | $63 - $98 | 217% |
| Triwest - All Plans | $63 | 217% |
| UnitedHealthcare | $63 - $93 | 217% |
| Humana | $63 | 217% |
| Aetna | $78 | 268% |
| First Health - All Plans | $88 | 303% |
| Wppa (Provdrscare) - All Plans | $93 | 320% |
| Health Partners - All Plans | $93 | 320% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services, Hodgeman County Health Center in Jetmore, KS, has a cash median price of $78.00 and a median negotiated rate of $69.00. It is important to note that while the facility is a Critical Access Hospital with government ownership, the cash price is significantly higher than the Medicare benchmark of $29.06, which serves as the objective baseline for fair pricing. Commercial insurance plans in this area typically negotiate rates ranging from $47 to $98, with Medicaid/KanCare plans showing a low of $63 and a high of $98 across three plans. Because insurance administrative structures often inflate baseline prices by 20% to 40%, patients with high-deductible plans may find that paying the cash price of $78.00 upfront is more cost-effective than relying on an insurance plan that might negotiate a rate exceeding this amount.
Patients should verify their specific plan details before scheduling, as in-network rates vary significantly by carrier and can sometimes be higher than cash prices due to multi-layered contract dynamics. For instance, Blue Cross Blue Shield plans have a low of $47, while UnitedHealthcare and Triwest range between $63 and $93. To ensure you are not overpaying, it is recommended to ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% for upfront payment. Additionally, if you have out-of-network coverage or encounter unexpected charges, you may be eligible for protections under the No Surprises Act, which bans balance billing for emergency and