Physical therapy (therapeutic exercise)
Facility: Girard Medical Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $41
- Cash Discount Price: $71
- vs. Medicare Baseline: 1.41x 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 |
|---|---|---|
| Humana | $41 | 141% |
| UnitedHealthcare | $41 - $112 | 141% |
| Kansas Superior Select-All Plans | $41 | 141% |
| Medicare (plans) | $41 | 141% |
| Blue Cross Blue Shield | $41 - $57 | 141% |
| Aetna | $41 - $206 | 141% |
| Ambetter / Centene | $41 | 141% |
| Multiplan-All Plans | $109 | 375% |
| Uhhis-All Plans | $112 | 385% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy (therapeutic exercise), the gross charge at Girard Medical Center in Girard, KS, is $118.00. The facility's cash median rate is $71.00, which is significantly lower than the negotiated rates paid by insurance carriers. While the median negotiated amount across payers is $41.00, some plans like Aetna and UnitedHealthcare have ranges extending up to $206 and $112 respectively, indicating substantial variation based on specific plan contracts. Patients with high-deductible plans may find the cash price of $71.00 more affordable than their insurance allowed amount, especially if their deductible has not yet been met. It is important to note that while the facility is a Critical Access Hospital owned by a Government Hospital District, the negotiated rates reflect the administrative costs and contract dynamics typical of commercial insurance billing.
To minimize unexpected costs, consumers should verify if the facility offers "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill. Additionally, patients should request an itemized billing audit rather than accepting a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. If a balance bill arises from an out-of-network service, the No Surprises Act may provide protection against paying the difference between the provider's chargemaster and the insurance allowed amount. For accurate pricing comparisons, it is recommended to evaluate rates against the Medicare benchmark of $29.06 rather than the facility's inflated gross charges, as Medicare rates represent a scientifically validated