Physical therapy (therapeutic exercise)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $62
- Cash Discount Price: $145
- vs. Medicare Baseline: 2.13x 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 213% of the Medicare baseline (a markup of 113%). 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 |
|---|---|---|
| Medicaid / KanCare | $28 | 96% |
| Tricare | $60 | 206% |
| Va_Ccn | $62 | 213% |
| Humana | $62 | 213% |
| Aetna | $62 | 213% |
| Medicare (plans) | $62 | 213% |
| Blue Cross Blue Shield | $62 - $63 | 213% |
| Medadv_Uhc | $62 | 213% |
| Medadv_Allwell | $62 | 213% |
| Ambetter / Centene | $98 | 337% |
| United | $161 | 554% |
| Wppa_Providrscare | $161 | 554% |
| Hpk | $184 | 633% |
| Cigna | $184 | 633% |
| Coventry | $184 | 633% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing physical therapy services, Neosho Memorial Regional Medical Center in Chanute, KS, lists a gross charge of $194.00. While the facility's cash median rate is $145.00 and the median negotiated rate across payers is $62.00, these figures should be evaluated against the Medicare benchmark of $29.06. Under federal Medicare benchmarking principles, commercial rates often range from 200% to 300% of the Medicare rate, whereas fair pricing is typically defined as 120% to 150%. In this instance, the cash price of $145.00 represents approximately 498% of the Medicare rate, which significantly exceeds the standard fair pricing range. Patients with high-deductible plans may find that paying the cash price directly is more cost-effective than using insurance, as the negotiated rate of $62.00 still exceeds the cash option, though the patient would likely face higher out-of-pocket costs if their deductible has not yet been met.
It is important to note that the facility is a Critical Access Hospital with government-local ownership, and the data reflects a vintage of 2026-06. Before scheduling, patients should explicitly request "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% by bypassing administrative claim processing fees. Additionally, while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services at in-network facilities, patients should verify their specific plan details to ensure no unexpected charges occur. Given that