CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Hermann Area District Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $56
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Hermann Area District Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $74 (255%)
Insurance Median: $56 (193%)
Cash: $74 (255% of Medicare)
Ins. Median: $56 (193% 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.

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
Healthy Blue Mcaid - All Plans $25 86%
Ambetter / Centene $26 - $100 89%
Blue Cross Blue Shield $27 - $106 93%
UnitedHealthcare $27 - $106 93%
Tricare $47 - $50 162%
Choicecare Mcr Adv- All Plans $50 - $53 172%
Harmony Hp Mcaid- All Plans $50 172%
Care Partners Mcaid- All Plans $52 179%
American Hlth Mcr Adv- All Plans $53 - $55 182%
Humana $53 - $55 182%
Aetna $54 - $119 186%
Wellcare Mcr Adv - All Plans $54 - $56 186%
Cigna $71 - $75 244%
Healthcare Usa Mcaid- All Plans $78 - $82 268%
Healthlink Hmo $78 - $82 268%
Healthlink Ppo - All Other Plans $90 - $94 310%
Multiplan/Phcs - All Plans $90 - $94 310%
Coventry - All Plans $102 - $107 351%
Comp Results - All Plans $108 - $113 372%
Three Rivers - All Plans $108 - $113 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 W 18Th St, Hermann, MO 65041
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals