CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: North Carolina Baptist Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $57
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at North Carolina Baptist Hospital is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.96x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $87 (299%)
Insurance Median: $57 (196%)
Cash: $87 (299% of Medicare)
Ins. Median: $57 (196% 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
Aetna $28 - $151 96%
Apex $28 96%
Blue Cross Blue Shield $28 - $60 96%
Cigna $28 - $187 96%
Devoted $28 96%
Healthteam $28 96%
Humana $28 - $97 96%
Medicare (plans) $28 96%
UnitedHealthcare $28 - $61 96%
Wellcare $28 - $41 96%
Liberty $32 110%
Medcost $33 - $118 114%
Amerihealth $38 - $48 131%
Carolina Complete $38 - $40 131%
Health Blue $38 - $40 131%
Partners $38 - $40 131%
Vaya $38 - $41 131%
Alliance $39 - $41 134%
Trillium $39 - $41 134%
Ambetter / Centene $45 - $48 155%
Oscar $50 - $64 172%
Directnet $99 - $105 341%
Cone Health $118 - $125 406%
Healthgram $118 - $125 406%
First Carolina Care $134 - $142 461%
Private Healthcare Systems $138 - $146 475%
Multiplan $151 - $160 520%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals