CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Howard County Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $114
Cash Discount Price: $214
vs. Medicare Baseline: 3.92x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Howard County Medical Center is $114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $214. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.92x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$214

Average discount available for prompt cash payment at this facility.

Insurance Median

$114

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: $214 (736%)

Insurance Median: $114 (392%)

Cash: $214 (736% of Medicare)

Ins. Median: $114 (392% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 392% of the Medicare baseline (a markup of 292%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Molina Healthcare	$20 - $214	69%
Nebraska Total Care	$20 - $214	69%
UnitedHealthcare	$20 - $411	69%
Aetna	$23 - $407	79%
Blue Cross Blue Shield	$23 - $407	79%
Great Plains	$23 - $244	79%
Humana	$23	79%
Medica Chi	$23 - $244	79%
Medica Standard Premier	$27	93%
Tricare	$27 - $321	93%
Medica Elevate	$28 - $54	96%
Nebraska Total Care - Wellcare	$28	96%
Medica Chi Aco	$37 - $389	127%
Medica Choice National	$37 - $389	127%
Medica Ifb Aco	$39 - $411	134%
Medica Ifb Open Access	$39 - $411	134%
Ambetter / Centene	$41	141%
Oscar Health	$48	165%
Beshp	$55	189%
Midland'S Choice	$57	196%

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 $214.
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 Howard County Medical Center 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.