CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $29
Cash Discount Price: $147
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Memorial Mission Hospital and Asheville Surgery Ce is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$29

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: $147 (506%)

Insurance Median: $29 (100%)

Cash: $147 (506% of Medicare)

Ins. Median: $29 (100% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$25 - $106	86%
Alignment Health	$25 - $28	86%
Humana	$25 - $29	86%
United	$25 - $87	86%
United Behavioral Health	$25 - $28	86%
Wellcare	$25 - $29	86%
Provider Partners Health Plan	$26 - $30	89%
Pruitthealth Premier	$26 - $29	89%
Blue Cross Blue Shield	$27	93%
Cigna	$27 - $73	93%
Healthteam Advantage	$27 - $31	93%
Troy Healthcare	$27 - $30	93%
Amerihealth	$28	96%
Amerihealth Caritas	$28 - $69	96%
Partners Health Management	$28	96%
Vaya Health	$28	96%
Apex Health	$29	100%
Longevity Health Plan	$30 - $34	103%
Oscar	$52	179%
Caresource	$65	224%
Medcost	$83 - $125	286%
Magellan	$88	303%
Magellan Behavioral Health	$88	303%
Multiplan	$118	406%
Avalon Administrative Services	$125	430%
Prime Health	$129 - $132	444%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $147.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Memorial Mission Hospital and Asheville Surgery Ce is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.