CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Charlevoix Area Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $65
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 2.24x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Charlevoix Area Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.24x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $69 (237%)
Insurance Median: $65 (224%)
Cash: $69 (237% of Medicare)
Ins. Median: $65 (224% 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 224% of the Medicare baseline (a markup of 124%). 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
Blue Cross Blue Shield $20 - $75 69%
Mclaren Health Plan $20 - $75 69%
Meridian $20 69%
Priority Health $20 - $85 69%
UnitedHealthcare $20 - $70 69%
Aetna $28 - $73 96%
Blue Care Network $28 - $38 96%
Hap (Health Alliance Plan) $28 - $65 96%
Medicare (plans) $28 - $38 96%
Michigan Amish Medical Board $28 - $38 96%
Molina $28 - $41 96%
Northern Michigan Mennonite Group $28 - $38 96%
Provider Network Of America/Hma Group Health $39 - $69 134%
Asr Physicians Care Network $42 - $65 145%
Nomi Health $45 - $75 155%
Employee Benefits Logistics $47 - $65 162%
Hospice Of Michigan $49 169%
Enterprise Group Planning Employee Benefit Plan $65 224%
First Health/Coventry Health/Community Care Network $65 224%
Medical Cost Savings Solution $65 224%
Three Rivers Provider Network $69 237%
Cofinity $75 258%
Iba Health And Life Assurance Company $75 258%
Preferred Medical Claim Solutions $77 265%
Cigna $81 - $85 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14700 Lakeshore Drive, Charlevoix, MI 49720
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals