CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Southern Hills Hospital and Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $65
  • Cash Discount Price: $368
  • vs. Medicare Baseline: 2.24x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Southern Hills Hospital and Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.24x the Medicare baseline. Located in 9300 West Sunset Rd, Las Vegas, NV.
Cash / Self-Pay
$368

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $368 (1266%)
Insurance Median: $65 (224%)
Cash: $368 (1266% of Medicare)
Ins. Median: $65 (224% 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 224% of the Medicare baseline (a markup of 124%). 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 $4 - $55 14%
Humana $25 - $29 86%
Alignment Health Plan $26 - $29 89%
Ambetter / Centene $26 - $79 89%
Blue Cross Blue Shield $26 - $29 89%
Caremore $26 - $30 89%
Hometown Health Mcr $26 - $29 89%
Select Health $26 - $86 89%
Triwest $26 - $29 89%
United $26 - $82 89%
Community Care Health $28 96%
Imperial Nv $28 - $32 96%
Molina Healthcare $28 - $29 96%
Sierra Hpn $28 96%
Caresource $29 100%
Health Net $29 100%
Universal Healthcare $31 - $35 107%
Corvel $65 224%
Olympus Medsave Usa $68 - $281 234%
Prominence Healthfirst $108 - $112 372%
Cmn Global $151 - $158 520%
Evernorth $180 - $188 619%
Hometown Health Providers $180 - $188 619%
Nv Health & Welfare Trust $216 - $225 743%
Multiplan $227 - $274 781%
First Health $238 - $300 819%
Medcare International $270 - $281 929%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 West Sunset Rd, Las Vegas, NV 89148
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals