CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: West Carroll Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $88
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at West Carroll Memorial Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.03x the Medicare baseline. Located in 706 Ross Street, Oak Grove, LA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)

Insurance Median: $88 (303%)

Ins. Median: $88 (303% of 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 303% of the Medicare baseline (a markup of 203%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$33 - $88	114%
Amerihealth Caritas Louisiana	$33	114%
Healthy Blue	$33	114%
Louisiana Healthcare Connections	$33	114%
Medicaid / KanCare	$44	151%
UnitedHealthcare	$44 - $136	151%
Physicians Mutual Insurance Company	$58	200%
Mutual Of Omaha Companies Claims Department	$88	303%
United Of Omaha Life Insurance Company	$88	303%
Woodmenlife Claims Department	$88	303%
Omaha Insurance Company	$117	403%
Blue Advantage	$136	468%
Humana	$154	530%
Tricare	$172	592%
Lwcc	$280	964%
Insurance Systems Inc	$372	1280%
Bankers Life And Casualty Company	$438	1507%
Christian Care Medi-Share	$438	1507%
Novitas Solutions	$438	1507%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm West Carroll Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.