CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Maimonides Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $31
Cash Discount Price: $193
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Maimonides Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $193. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.

Cash / Self-Pay

$193

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

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: $193 (664%)

Insurance Median: $31 (107%)

Cash: $193 (664% of Medicare)

Ins. Median: $31 (107% 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.

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
Blue Cross Blue Shield	$11 - $132	38%
Aetna	$15 - $51	52%
Healthfirst	$16 - $66	55%
UnitedHealthcare	$16 - $32	55%
Oxford Health Plan	$19 - $25	65%
Fidelis	$20 - $52	69%
Oxford Liberty	$28	96%
United Community Plan	$34	117%
Emblem Health - Ghi	$35 - $95	120%
Metroplus	$37	127%
Local 1199	$50	172%
Centivo	$52	179%

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 $193.
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 Maimonides 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.