CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Wooster Community Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $109
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 3.75x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Wooster Community Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.75x the Medicare baseline. Located in 1761 Beall Avenue, Wooster, OH.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$109

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: $136 (468%)
Insurance Median: $109 (375%)
Cash: $136 (468% of Medicare)
Ins. Median: $109 (375% 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 375% of the Medicare baseline (a markup of 275%). 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
Tricare $27 93%
Blue Cross Blue Shield $28 - $125 96%
Buckeye Mcare $28 96%
Caresource Mcr Adv $28 96%
Humana $28 - $128 96%
Med Mutual Of Oh Mcr $28 96%
Molina Mcr $28 96%
Summacare Mcr $28 96%
The Health Plan Mcr Adv $28 96%
UnitedHealthcare $28 - $129 96%
Valor Hp Mcr-All Plans $28 96%
Magnipower-All Plans $36 124%
Caresource Exch - All Other Plans $40 138%
Molina Marketplace - All Other Plans $47 162%
Clarity Health - All Plans $54 186%
Aultcare/Primecare Mcr Adv $67 231%
Buckeye Mcaid-All Other Plans $74 255%
Caresource Mcaid $74 255%
Molina Mcaid $76 262%
Aetna $78 - $136 268%
Amerihealth Mcaid-All Plans $78 268%
Cerco-All Plans $95 327%
Aultcare Wayne County $102 351%
Aultcare/Primetime Exch $102 351%
Rayco-All Plans $102 351%
Christian Health Ministries-All Plans $109 375%
Cigna $109 375%
Health Ohio Network Employer $109 375%
Wayne County-All Plans $109 375%
Healthsmart Accel $113 389%
Summacare Preferred Choice $113 389%
Health Ohio Network Ppo-All Other Plans $116 399%
Healthsmart Complete Ppo-All Other Plans $116 399%
Ohio Health Choice Supp $116 399%
Ohio Health Group Hlthy - All Other Plans $116 399%
Med Mutual Of Oh Exchange $117 403%
Med Mutual Of Oh Supermed $117 403%
Med Mutual Of Oh Trad-All Other Plans $117 403%
Health Plan Of Upper Ohio-All Plans $120 413%
The Health Plan Comm - All Other Plans $120 413%
Ohio Health Group Pref $121 416%
Aultcare/Primetime-All Other Plans $123 423%
Healthsmart Ppo $124 427%
Summacare-All Other Plans $127 437%
Ohio Health Choice-All Other Plans $128 440%
Healthsmart Hpo $129 444%
Osu-All Plans $129 444%
Central Benefits-All Plans $131 451%
First Health-All Plans $131 451%
Flora-All Plans $131 451%
Beech Street-All Plans $132 454%
Phcs-All Plans $132 454%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1761 Beall Avenue, Wooster, OH 44691
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals