Physical therapy (therapeutic exercise)
Facility: Smith County Memorial Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $88
- Cash Discount Price: $94
- vs. Medicare Baseline: 3.03x 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 303% of the Medicare baseline (a markup of 203%). 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 | $49 | 169% |
| Medicaid / KanCare | $66 - $94 | 227% |
| Multiplan-All Plans | $85 | 292% |
| Wppa-All Plans | $88 | 303% |
| UnitedHealthcare | $89 | 306% |
| Midlands Choice-All Plans | $89 | 306% |
| Health Partners Of Ks Ppo-All Plans | $89 | 306% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services at Smith County Memorial Hospital in Smith Center, Kansas, the cash price is $94.00. This rate is notably higher than the facility's negotiated average of $88.00, which aligns with the median negotiated rate across all payers. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if the patient's deductible has not yet been met or if the insurance negotiated rate exceeds the cash price. It is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed.
When comparing this facility's pricing to broader benchmarks, the Medicare amount for this service is $29.06. The facility's cash rate of $94.00 represents a 3.0x markup relative to the Medicare benchmark, which is significantly higher than the typical fair pricing range of 120% to 150% of Medicare. This disparity highlights the importance of understanding that commercial rates often include administrative overhead and network tiering factors that do not reflect the true cost of care. Consumers are encouraged to request an itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be disputed to lower the total charge.