Physical therapy (therapeutic exercise)
Facility: Memorial Hospital
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $74
- Cash Discount Price: $131
- vs. Medicare Baseline: 2.55x 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 255% of the Medicare baseline (a markup of 155%). 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 | $52 | 179% |
| Tricare | $63 - $68 | 217% |
| Humana | $63 - $68 | 217% |
| Medicare (plans) | $64 - $68 | 220% |
| Ambetter / Centene | $70 - $74 | 241% |
| Coventry - All Other Plans | $114 - $122 | 392% |
| Health Partners Of Kansas - All Plans | $120 - $128 | 413% |
| Preferred Healthcare-All Plans | $120 - $128 | 413% |
| Wppa/Providers Care-All Plans | $177 - $189 | 609% |
Consumer Guidance & Cost Commentary
For the CPT code 97110, representing therapeutic exercise at Memorial Hospital in Abilene, KS, the cash price is $131.00, which matches the facility's median paid amount. This cash rate is significantly higher than the state average, reflecting the typical markup found in commercial billing where negotiated rates often exceed fair pricing benchmarks. While Medicare sets a baseline of $29.06 for this service, commercial payers negotiate rates ranging from $52 to $189 depending on the plan, with the lowest negotiated amount being $52.00. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $131.00 cash rate is lower than the median negotiated rate of $122.00 for many commercial payers, effectively bypassing administrative overhead and potential deductibles.
To minimize costs, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the bill by 20% to 50% by avoiding insurance billing cycles and administrative fees. It is important to verify that the facility is in-network for your specific plan, as in-network status does not guarantee the lowest possible price, and some commercial contracts may still result in higher allowed amounts than the cash rate. Additionally, if you receive a bill from an out-of-network provider at this facility, the No Surprises Act may protect you from balance billing for emergency or non-emergency services, so you should review your itemized statement carefully to ensure no unexpected charges exist before making a payment.