CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Insight Hospital and Medical Center Coldwater

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $83
  • Cash Discount Price: $97
  • vs. Medicare Baseline: 2.86x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Insight Hospital and Medical Center Coldwater is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $97. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.86x the Medicare baseline. Located in 274 E Chicago St, Coldwater, MI.
Cash / Self-Pay
$97

Average discount available for prompt cash payment at this facility.

Insurance Median
$83

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: $97 (334%)
Insurance Median: $83 (286%)
Cash: $97 (334% of Medicare)
Ins. Median: $83 (286% 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 286% of the Medicare baseline (a markup of 186%). 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
Medicaid / KanCare $62 - $83 213%
Medicare (plans) $62 - $83 213%
UnitedHealthcare $62 - $83 213%
Aetna $83 - $88 286%
Blue Cross Blue Shield $83 286%
Cofinity $83 286%
Frontpath $83 286%
Hap $83 286%
Health Alliance Plan $83 286%
Humana $83 - $88 286%
Mclaren $83 286%
Multi-Plan $83 286%
Paramount Elite $83 286%
Paramount Hmo $83 286%
Paramount Ppo $83 286%
Phcs $83 286%
Php Northern Indiana $83 286%
Php Of Mid Michigan $83 286%
Priority $83 286%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 274 E Chicago St, Coldwater, MI 49036
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals