Physical therapy (therapeutic exercise)
Facility: Clearsky Rehabilitation Hospital Of Elwood St Joseph Llc
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $65
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.24x 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 224% of the Medicare baseline (a markup of 124%). 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 |
|---|---|---|
| Multiplan | $48 - $77 | 165% |
| Cigna | $53 - $85 | 182% |
Consumer Guidance & Cost Commentary
For this Physical therapy (therapeutic exercise) service at Clearsky Rehabilitation Hospital Of Elwood St Joseph Llc, the facility's negotiated rate of $65.00 is significantly higher than the state average, which is 2.2 times the Medicare benchmark of $29.06. While commercial insurance plans like Multiplan and Cigna have negotiated rates ranging from $48 to $85, these amounts often exceed what a patient would pay out-of-pocket. Because commercial negotiated rates include administrative overhead and contract premiums, they can sometimes be more expensive than the cash price. If you have a high-deductible plan where your deductible has not yet been met, paying the full cash price or utilizing a prompt-pay discount may result in lower out-of-pocket costs compared to having insurance process the claim at the higher negotiated rate.
To ensure you are receiving the best possible price, it is important to verify the facility's self-pay or prompt-pay discounts before scheduling your visit, as these can reduce the final bill by 20% to 50%. Since the facility is a Part A Provider in Kansas, you should also review your specific plan details to confirm whether the negotiated rate applies to your situation or if you might qualify for a lower cash rate. Finally, if you receive an itemized bill, request a full line-by-line statement to check for any errors or unbundled charges, as over 80% of hospital bills contain mistakes that can be corrected through a formal written audit dispute.