CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $300
  • Cash Discount Price: $433
  • vs. Medicare Baseline: 10.32x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at University Medical Center of Princeton at Plainsboro is $300. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 10.32x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$433

Average discount available for prompt cash payment at this facility.

Insurance Median
$300

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: $433 (1490%)
Insurance Median: $300 (1032%)
Cash: $433 (1490% of Medicare)
Ins. Median: $300 (1032% 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 1032% of the Medicare baseline (a markup of 932%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $32 - $361 110%
Blue Cross Blue Shield $32 - $326 110%
Medicare (plans) $32 - $35 110%
Tricare $32 110%
UnitedHealthcare $32 - $158 110%
Us Family Health Plan $32 110%
Va Medical Center $32 110%
Cigna $33 - $433 114%
Clover Health Plan $34 117%
Humana $35 120%
Medicaid / KanCare $40 - $433 138%
Charity Care $41 141%
Wellcare $44 151%
Elap $46 - $58 158%
Centivo $58 200%
Claim Watcher $58 200%
Horizon Nj Health $60 206%
Preferred Health Care Eliance $113 389%
Horizon Behavioral Health $162 557%
Beacon Health Options $216 743%
Amerihealth $256 881%
Princeton Theological Seminary $281 967%
Magnacare $299 - $303 1029%
Coventry $303 1043%
Health Net $303 1043%
First Managed Care Option $308 - $368 1060%
Beech Street $346 - $368 1191%
Intergrated Health Plan $346 1191%
Intergroup $346 1191%
Penn Global Medicine Embassy Only $346 1191%
Allied Trades $368 1266%
Consumer Health Network $368 1266%
Devon Health Services $368 1266%
Ie Shaffer $368 1266%
Private Healthcare Systems $368 1266%
Qualcare $368 1266%
Total Care Network $368 1266%
Tri-State $368 1266%
Commercial Other $433 1490%
Compsych $433 1490%
Concern Plus $433 1490%
International Pfs $433 1490%
Life St. Francis $433 1490%
Magellan $433 1490%
Managed Health Network $433 1490%
Nj Carpenters $433 1490%
Penn Behavioral Health Corporate Services $433 1490%
Personnel Health Program $433 1490%
United Behavioral Health $433 1490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals