Physical therapy (therapeutic exercise)
Facility: Kingman Healthcare Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $136
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.68x 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 468% of the Medicare baseline (a markup of 368%). 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 |
|---|---|---|
| Humana | $136 | 468% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy therapeutic exercise, Kingman Healthcare Center in Kingman, KS, has a median negotiated rate of $136.00. This rate is significantly higher than the state average, which is 4.7 times the Medicare benchmark of $29.06. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the data indicates no available cash or median paid figures for this specific service. Patients should be aware that cash-pay options can sometimes be more cost-effective for those with high-deductible plans if the insurance negotiated rate exceeds the cash price, though current data does not reflect a specific cash rate for this procedure.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Since the facility is in-network, the negotiated rate serves as a ceiling, but patients should still verify their deductible status and ask about prompt-pay discounts, which can range from 20% to 50% for upfront payments. If you receive a summary bill, insist on a full itemized statement to identify any discrepancies, and avoid verbal disputes by sending a formal written audit request to the billing supervisor. Always confirm whether ancillary services like laboratory tests are billed separately, as these can trigger unexpected balance billing even at in-network facilities.