Physical therapy (therapeutic exercise)
Facility: Mitchell County Hospital Health Systems
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $85
- Cash Discount Price: $80
- vs. Medicare Baseline: 2.92x 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 292% of the Medicare baseline (a markup of 192%). 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 |
|---|---|---|
| UnitedHealthcare | $28 - $89 | 96% |
| Blue Cross Blue Shield | $49 | 169% |
| Triwest Well Mark All Plans | $76 | 262% |
| First Health-All Plans | $80 | 275% |
| Aetna | $80 | 275% |
| Pref Hlth Care Sytms Comm - All Plans | $80 | 275% |
| Multiplan Ppo - All Plans | $85 | 292% |
| Auxiant-All Plans | $85 | 292% |
| Phc Leased Ntwrk Access - All Plans | $85 | 292% |
| Health Partners Ks-All Plans | $88 | 303% |
| Cigna | $88 | 303% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services, Mitchell County Hospital Health Systems in Beloit, KS, lists a cash median price of $80.00 and a median negotiated rate of $85.00. This cash price is notably lower than the facility's gross charge of $89.00 and aligns closely with the state average for this service. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance plans, such as UnitedHealthcare and Blue Cross Blue Shield, negotiate rates ranging from $28.00 to $89.00 depending on the specific plan. Although these negotiated rates often serve as a ceiling to protect in-network members, they can sometimes exceed the cash price, making self-pay options potentially more cost-effective for those with high-deductible plans or those who have already met their out-of-pocket maximum.
To secure the most favorable rate, patients are encouraged to explicitly request "self-pay" or "prompt-pay" discounts before scheduling their visit, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees. It is also important to distinguish between the facility's negotiated rate and the Medicare benchmark of $29.06; commercial rates often reflect a markup that includes administrative overhead and contract dynamics, whereas Medicare rates represent a more standardized cost baseline. If a patient receives an itemized bill that includes unexpected charges or appears to be a summary rather than a detailed statement, they should request a full audit to identify any unbundled codes or services not rendered, ensuring they are only paying for the actual care received.