CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Cambridge Health Alliance

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $125
  • Cash Discount Price: $253
  • vs. Medicare Baseline: 4.30x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Cambridge Health Alliance is $125. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $253. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.30x the Medicare baseline. Located in 1493 Cambridge Street, Cambridge, MA.
Cash / Self-Pay
$253

Average discount available for prompt cash payment at this facility.

Insurance Median
$125

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%)
Cash / Self-Pay: $253 (871%)
Insurance Median: $125 (430%)
Cash: $253 (871% of Medicare)
Ins. Median: $125 (430% 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 430% of the Medicare baseline (a markup of 330%). 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.

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
Wc [90001] $31 107%
Aetna $42 - $380 145%
Other Tufts Health Public Plan [75002] $55 189%
Wellpoint [50012] $55 189%
Health Plans Inc [20002] $69 - $312 237%
Hphc [20001] $69 - $312 237%
UnitedHealthcare $69 - $312 237%
Cigna $73 - $380 251%
Mass General Brigham [50021] $80 - $242 275%
Aarp [40001] $81 - $188 279%
Oxford Health [40004] $81 - $188 279%
United Medical Resource [40005] $81 - $188 279%
Multiplan [50010] $85 - $258 292%
Tufts Health Plan [30001] $92 - $107 317%
Blue Cross Blue Shield $102 - $380 351%
Altus Dental [99011] $125 - $380 430%
Beacon Health Strategies [50002] $125 - $380 430%
Cbhc Uninsured Crisis Alt Payer [70097] $125 - $380 430%
Cbhc Uninsured Crisis [70096] $125 - $380 430%
Celticare [50004] $125 - $380 430%
Commonwealth Care Alliance Dental [99004] $125 - $380 430%
Coverage Discovery [90004] $125 - $380 430%
Delta Dental Of Ma [99007] $125 - $380 430%
Dominion National Dental [99012] $125 - $380 430%
Dph Tb Payor [85004] $125 - $380 430%
Esp Dental [99003] $125 - $380 430%
Eyemed Alt Payor [13001] $125 - $380 430%
First Health [50007] $125 - $380 430%
Global Medical Management [50024] $125 - $380 430%
Government Employee Health Association [50023] $125 - $380 430%
Guardian Dental [99013] $125 - $380 430%
Health Safety Net Dental [99002] $125 - $380 430%
Humana $125 - $380 430%
Ma Laborers Health And Welfare Fund [50022] $125 - $380 430%
Magellan Health Services [65098] $125 - $380 430%
Mass Health Dental [99001] $125 - $380 430%
Medical Mutual Of Ohio [50019] $125 - $380 430%
Medicare (plans) $125 - $380 430%
Metlife Dental [99008] $125 - $380 430%
Modern Assistance Program [30098] $125 - $380 430%
Mva [90002] $125 - $380 430%
Neighborhood Health Plan [50011] $125 - $380 430%
Other Bh Payor [50014] $125 - $380 430%
Other Commercial Payor [50015] $125 - $380 430%
Other Dental Payor [99014] $125 - $380 430%
Other Dual Eligible Payer [65004] $125 - $380 430%
Other Gov'T Alt [85006] $125 - $380 430%
Other Vision Payor [50013] $125 - $380 430%
Ri Neighborhood Health Plan [50017] $125 - $380 430%
Tricare $125 - $380 430%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1493 Cambridge Street, Cambridge, MA 02139
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals