CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Blue Ridge Regional Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $42
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Blue Ridge Regional Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.45x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $106 (365%)
Insurance Median: $42 (145%)
Cash: $106 (365% of Medicare)
Ins. Median: $42 (145% 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
Blue Cross Blue Shield $14 - $20 48%
United $15 - $58 52%
Amerihealth $16 - $21 55%
Partners Health Management $16 - $22 55%
Vaya Health $16 - $22 55%
Wellcare $16 - $21 55%
Aetna $18 - $88 62%
Apex Health $18 - $24 62%
Cigna $31 - $50 107%
Amerihealth Caritas $33 - $45 114%
Caresource $40 - $54 138%
Medcost $42 - $63 145%
Magellan $54 - $73 186%
Magellan Behavioral Health $54 - $73 186%
Multiplan $72 - $98 248%
Avalon Administrative Services $77 - $104 265%
Prime Health $80 - $110 275%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals