CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: St John's Riverside Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $33
Cash Discount Price: $553
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at St John's Riverside Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $553. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.14x the Medicare baseline. Located in 976 North Broadway, Yonkers, NY.

Cash / Self-Pay

$553

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $553 (1903%)

Insurance Median: $33 (114%)

Cash: $553 (1903% of Medicare)

Ins. Median: $33 (114% 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
Fidelis Essential Plans	$28	96%
Medicaid / KanCare	$28	96%
Fidelis Health Benefit Exchange	$31	107%
Aetna	$33 - $3,783	114%
Centers Plan For Healthy Living	$33	114%
Fidelis	$33	114%
Healthfirst	$33	114%
Hip Health Plan	$33	114%
Magnacare	$33	114%
Medicare (plans)	$33	114%
Mvp	$33	114%
Mvp Bhs	$33	114%
Oscar	$33 - $35	114%
Partners Health Plan	$33	114%
United Behavioral Health Of Ny Ipa	$33	114%
Village Caremax	$33	114%
Wellcare	$33	114%
Metroplus Gold	$35	120%
Emblem Health	$88 - $207	303%
Empire Hmo	$100	344%
Mvp Individual Exchange.Student Health Plan	$148	509%
UnitedHealthcare	$169 - $171	582%
Mvp Commercial	$175	602%
Cigna	$207	712%

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 $553.
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 St John's Riverside Hospital 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.