CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Healthsource Saginaw

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $525
Cash Discount Price: Unavailable
vs. Medicare Baseline: 18.07x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Healthsource Saginaw is $525. 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 18.07x the Medicare baseline. Located in 3340 Hospital Road, Saginaw, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$525

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: $525 (1807%)

Ins. Median: $525 (1807% 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 1807% of the Medicare baseline (a markup of 1707%). 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
Humana	$28	96%
Meridian Health Plan	$28 - $659	96%
Molina Healthcare	$28 - $610	96%
Priority Health	$28 - $1,800	96%
Midmichigan Health Network	$1,080	3716%
Northern Michigan Regional Entity	$1,082 - $1,156	3723%
Genesse Health System	$1,134	3902%
Lapeer County Community Mental Health	$1,134	3902%
Livingston County Community Mental Health	$1,134	3902%
St. Clair County Community Mental Health	$1,134	3902%

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 Healthsource Saginaw 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.