CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Essentia Health Ada

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $90
  • Cash Discount Price: $101
  • vs. Medicare Baseline: 3.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Essentia Health Ada is $90. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.10x the Medicare baseline. Located in 201 9Th Street West, Ada, MN.
Cash / Self-Pay
$101

Average discount available for prompt cash payment at this facility.

Insurance Median
$90

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: $101 (348%)
Insurance Median: $90 (310%)
Cash: $101 (348% of Medicare)
Ins. Median: $90 (310% 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 310% of the Medicare baseline (a markup of 210%). 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
Itasca Med Care $29 100%
Primewest $29 100%
Healthpartners Care Pmap $53 182%
Medica Access $55 - $85 189%
Sanford Health Plan $59 - $62 203%
Advocare/Security Health $66 227%
Blue Cross Blue Shield $66 - $119 227%
Freedom Blue Ppo $66 227%
Healthpartners Care Msho / Mcr Adv $66 227%
Imcare Msho Pcc Prime $66 227%
Imcare Msho Ref Req $66 227%
Medica Advantage Solutions $66 227%
Medica Msho/Dual Solutions $66 227%
Medica Prime Solution Group $66 227%
Medicare (plans) $66 227%
Nd Va Administration $66 227%
Platinum Blue/Vantage Blue $66 227%
Primewest Msho $66 227%
Secure Blue Msho $66 227%
Ubh Cost Plan $66 227%
Ubh Msho $66 227%
Ucare Msho $66 227%
UnitedHealthcare $66 - $124 227%
Blue Plus Pmap Pcc Prime $75 - $119 258%
Healthpartners $83 - $91 286%
Ucare $90 310%
Cigna $91 313%
Healthpartners Pcc Prime $91 313%
Wea $99 - $105 341%
America'S Ppo $106 365%
Medica $114 - $120 392%
Medica Uplan $114 392%
Wps $114 - $115 392%
Aetna $116 399%
Medica Choice $123 423%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 9Th Street West, Ada, MN 56510
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals