CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Covenant Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $49
Cash Discount Price: $127
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Covenant Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.69x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$49

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: $127 (437%)

Insurance Median: $49 (169%)

Cash: $127 (437% of Medicare)

Ins. Median: $49 (169% 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.

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
Blue Cross Blue Shield	$15 - $38	52%
Healthy Michigan Mclaren	$15 - $28	52%
Healthy Michigan Meridian	$15 - $28	52%
Healthy Michigan Molina	$15 - $28	52%
Healthy Michigan Priority Health	$15 - $28	52%
Health Advantage Mclaren Employee	$17 - $101	58%
Priority Health E	$17 - $84	58%
Physicians Health Plan	$20 - $101	69%
Priority Health	$20 - $101	69%
Aetna	$26 - $135	89%
Blue Care Network	$28 - $38	96%
Health Alliance Plan Of Michigan	$28 - $54	96%
Humana	$28 - $137	96%
Mclaren Advantage	$28	96%
Mclaren Health Advantage	$28 - $82	96%
Meritain Health	$28 - $140	96%
Molina Healthplan	$28	96%
Physicians Health Plan Advantage/Advantage Plus	$28	96%
Multiplan	$33 - $165	114%
Cigna	$100 - $101	344%

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 $127.
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 Covenant Medical Center 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.