CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Montefiore St Luke's Cornwall

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $167
Cash Discount Price: Unavailable
vs. Medicare Baseline: 5.75x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Montefiore St Luke's Cornwall is $167. 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 5.75x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$167

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: $167 (575%)

Ins. Median: $167 (575% 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 575% of the Medicare baseline (a markup of 475%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Healthfirst	$49 - $94	169%
Blue Cross Blue Shield	$59 - $262	203%
Emblem	$59 - $296	203%
Medicaid / KanCare	$59	203%
Hamaspik	$62	213%
Mvp	$75 - $214	258%
Aetna	$110 - $129	379%
Magnacare	$118	406%
Geha	$129	444%
Meritain Health	$129	444%
Nippon Life Insurance	$129	444%
Oscar	$250	860%
Cigna	$315	1084%
Centivo	$356	1225%
Northwell	$360	1239%
American Postal Workers	$473	1628%
UnitedHealthcare	$473	1628%

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 $X.
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 Montefiore St Luke's Cornwall 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.