CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Essentia Health St Joseph's Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $62
  • Cash Discount Price: $92
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Essentia Health St Joseph's Medical Center is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.13x the Medicare baseline. Located in 523 North 3Rd Street, Brainerd, MN.
Cash / Self-Pay
$92

Average discount available for prompt cash payment at this facility.

Insurance Median
$62

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: $92 (317%)
Insurance Median: $62 (213%)
Cash: $92 (317% of Medicare)
Ins. Median: $62 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Advocare/Security Health $29 100%
Blue Cross Blue Shield $29 - $96 100%
Freedom Blue Ppo $29 100%
Healthpartners Care Msho / Mcr Adv $29 100%
Imcare Msho Pcc Prime $29 100%
Imcare Msho Ref Req $29 100%
Itasca Med Care $29 100%
Medica Advantage Solutions $29 100%
Medica Msho/Dual Solutions $29 100%
Medica Prime Solution Group $29 100%
Medicare (plans) $29 100%
Nd Va Administration $29 100%
Platinum Blue/Vantage Blue $29 100%
Primewest $29 100%
Primewest Msho $29 100%
Secure Blue Msho $29 100%
Ubh Cost Plan $29 100%
Ubh Msho $29 100%
Ucare Msho $29 100%
UnitedHealthcare $29 - $104 100%
Blue Plus Pmap Pcc Prime $38 - $87 131%
Medica Access $43 148%
Healthpartners Care Pmap $59 203%
Sanford Health Plan $59 - $62 203%
Medica $87 - $97 299%
Medica Uplan $87 299%
Ucare $90 310%
Wea $99 - $105 341%
Medica Choice $100 344%
Cigna $101 348%
Healthpartners $101 348%
Healthpartners Pcc Prime $101 348%
America'S Ppo $106 365%
Wps $114 - $115 392%
Aetna $116 399%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 523 North 3Rd Street, Brainerd, MN 56401
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals