CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Metropolitan Hospital Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $205
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 7.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Metropolitan Hospital Center is $205. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 7.05x the Medicare baseline. Located in 1901 First Avenue, New York, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$205

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%)
Insurance Median: $205 (705%)
Ins. Median: $205 (705% 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 705% of the Medicare baseline (a markup of 605%). 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
Healthfirst $18 - $250 62%
Aetna $19 - $1,171 65%
Wellcare $35 120%
Centerlight $46 - $158 158%
Fidelis $47 - $221 162%
Carelon $60 - $758 206%
Elderplan $60 - $205 206%
Emblem $64 - $977 220%
Blue Cross Blue Shield $74 - $1,626 255%
Multiplan $74 - $253 255%
Local 1199 $78 - $796 268%
Villagecare Max $78 - $268 268%
Vnsny $78 - $268 268%
Metroplus $90 - $265 310%
Amidacare $98 337%
Senior Whole Health $98 337%
United $98 - $1,093 337%
United Behavioral Health $98 - $108 337%
Affinity $100 - $221 344%
Carelon (Amida Care) $100 344%
Oxford $236 - $882 812%
Magnacare $237 - $320 816%
Cigna $241 - $1,500 829%
Oscar $251 - $1,396 864%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1901 First Avenue, New York, NY 10029
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals