Physical therapy (therapeutic exercise)
Facility: Fredonia Regional Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $87
- Cash Discount Price: $97
- vs. Medicare Baseline: 2.99x 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 299% of the Medicare baseline (a markup of 199%). 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 | $48 - $57 | 165% |
| UnitedHealthcare | $49 - $229 | 169% |
| Aetna | $49 - $87 | 169% |
| Veterans Programs - All Plans | $49 | 169% |
| Meritain-All Plans | $87 | 299% |
| Cigna | $87 | 299% |
| Reserve National-All Plans | $87 | 299% |
Consumer Guidance & Cost Commentary
For this Physical therapy (therapeutic exercise) service at Fredonia Regional Hospital in Kansas, the cash price is $97.00, which matches the facility's median negotiated rate of $87.00 and the state average of $87.00. While the hospital's gross chargemaster is $97.00, patients with high-deductible plans may find paying cash directly more cost-effective than using insurance, as the negotiated rate of $87.00 is lower than the cash price. It is important to note that the Medicare benchmark for this code is $29.06, indicating that the commercial rates are significantly higher than the federal baseline. Patients should verify their specific plan details, as some commercial payers like UnitedHealthcare and Aetna have negotiated ranges starting at $49.00, which could result in lower out-of-pocket costs depending on their deductible status.
Before finalizing payment, consumers should proactively request a self-pay or prompt-pay discount from the billing department, as these upfront payment incentives can reduce the total amount owed. If a patient receives a bill after insurance submission, they should demand a full itemized audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, so any unexpected charges should be disputed with the insurer immediately. Given that this facility is a Critical Access Hospital with government local ownership, patients are encouraged to contact the hospital directly to confirm the most accurate self-pay rates and ensure no unnecessary administrative fees are applied.