CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $139
Cash Discount Price: $195
vs. Medicare Baseline: 4.78x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at UMass Memorial Health - Harrington Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $195. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.78x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$195

Average discount available for prompt cash payment at this facility.

Insurance Median

$139

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: $195 (671%)

Insurance Median: $139 (478%)

Cash: $195 (671% of Medicare)

Ins. Median: $139 (478% 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 478% of the Medicare baseline (a markup of 378%). 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
Cigna	$22 - $139	76%
Workers Compensation [20501]	$23	79%
Champva [11001]	$25	86%
Institution [10406]	$30	103%
Mgb Mcr [10124]	$30	103%
Tufts Us Family [11203]	$30	103%
Aetna	$31 - $195	107%
Blue Cross Blue Shield	$31 - $243	107%
Fallon Mcr Supp [20202]	$31	107%
Fallon Mcr [10105]	$31	107%
Tufts Mcr [10112]	$31	107%
UnitedHealthcare	$31 - $195	107%
Commonwealth Care Alliance [10103]	$32	110%
Senior Whole Health [10110]	$32	110%
Tufts Connectorcare [10507]	$52	179%
Wellpoint [11112]	$71	244%
Fallon Connectorcare [10503]	$72	248%
Medicaid / KanCare	$101	348%
Hne [11108]	$127	437%
Tufts [11201]	$139	478%
First Health Network [11120]	$146	502%
Evernorth Behavioral Health [27]	$156	537%
Connecticare [11105]	$195	671%
Fallon Carelon Hlth [28]	$195	671%
Fallon Mcaid Carelon Hlth [29]	$195	671%
Grants [20507]	$195	671%
Masshealth Mcd Mbhp [38]	$195	671%
Wellsense Mcaid Carelon Hlth [21]	$195	671%
Harvard Pilgrim [10701]	$202 - $242	695%
Hsno/Free Care [10801]	$681	2343%

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 $195.
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 UMass Memorial Health - Harrington 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.