Physical therapy (therapeutic exercise)
Facility: Children'S Mercy South
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $64
- Cash Discount Price: $59
- vs. Medicare Baseline: 2.20x 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 220% of the Medicare baseline (a markup of 120%). 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 |
|---|---|---|
| Cigna | $14 - $93 | 48% |
| UnitedHealthcare | $25 - $90 | 86% |
| Healthy Blue | $28 - $77 | 96% |
| Medicaid / KanCare | $28 - $33 | 96% |
| Home State Health | $31 - $68 | 107% |
| Wppa Providrs Care | $34 - $87 | 117% |
| Healthlink | $37 - $118 | 127% |
| Blue Cross Blue Shield | $39 - $99 | 134% |
| Health Midwest Comprehensive Care | $39 - $87 | 134% |
| Quiktrip | $39 - $87 | 134% |
| American Healthcare Alliance | $41 - $114 | 141% |
| Aetna | $49 - $91 | 169% |
| Multiplan | $49 - $102 | 169% |
| Wellfit/Centrus | $54 - $87 | 186% |
| Centivo | $56 - $87 | 193% |
| Nebraska Furniture Mart | $57 - $87 | 196% |
| Humana | $58 - $89 | 200% |
| Orscheln | $59 - $87 | 203% |
| Coventry Health Care Of Kansas | $62 - $99 | 213% |
| Medica | $64 - $78 | 220% |
| Mercy Health | $80 - $100 | 275% |
| Coxhealth Network | $81 - $99 | 279% |
| National Preferred Provider Network | $97 - $121 | 334% |
Consumer Guidance & Cost Commentary
For the Physical therapy (therapeutic exercise) service (CPT 97110) at Children's Mercy South in Overland Park, KS, the facility's cash price of $59.00 is significantly lower than the negotiated rates charged by most insurance payers. While the facility's cash rate is roughly double the Medicare benchmark of $29.06, many commercial plans negotiate rates ranging from $25 to $121, with the highest negotiated amount reaching $121 for National Preferred Provider Network. This disparity highlights a common pricing dynamic where in-network contracts often exceed cash prices due to administrative overhead and contract structures. For patients with high-deductible plans, paying the cash price of $59.00 upfront may result in substantial savings compared to the higher negotiated amounts their insurance would otherwise pay, provided they have not yet met their deductible.
Patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront payment incentives can further reduce the final bill by bypassing costly insurance claims processing. It is important to verify the specific allowed amount for your plan, as in-network rates vary widely across the 23 payers listed, with some plans like Medicaid/KanCare negotiating as low as $28 while others like Healthlink may reach $118. Additionally, while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, patients should always review their itemized bill to ensure no unbundled codes or services not rendered have been charged. Comparing the facility's pricing to the broader market reveals that while the cash rate is competitive, the final cost depends heavily on individual plan deductibles and the