CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Holmes County Hospital and Clinics

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $49
  • Cash Discount Price: $26
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Holmes County Hospital and Clinics is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $26. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.69x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$26

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $26 (89%)
Insurance Median: $49 (169%)
Cash: $26 (89% of Medicare)
Ins. Median: $49 (169% 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
Ms-Can-Magnolia-Lex $25 86%
Ms-Can-Molina-Lex $25 86%
Ms-Can-Truecare-Lex $25 86%
Advhealth-Lex $32 110%
Blue Cross Blue Shield $36 124%
Cigna $38 131%
Tricare $40 138%
Humana $41 141%
Mpcn-Lex $42 145%
Medadv_Uhc-Lex $44 151%
Firstchoice-Lex $46 158%
Ambetter / Centene $49 169%
Medadv_Primewell-Lex $49 169%
Medicare (plans) $49 169%
Primewell-Lex $49 169%
Va_Ccn-Lex $49 169%
Medadv_Uhcdsnp-Lex $50 172%
Wellcare-Lex $50 172%
Devoted_Health-Lex $51 175%
Ppoplus $51 175%
Firsthealth-Lex $52 179%
Multiplan-Lex $52 179%
Molina-Chip-Lex $53 182%
Magnolia-Chip-Lex $54 186%
Truecare-Chip-Lex $54 186%
Aetna $55 189%
Phcs-Lex $58 200%
Molina_Exchange-Lex $65 224%
United-Lex $65 224%
United-Options-Lex $65 224%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals