CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Cleveland Clinic

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $93
  • Cash Discount Price: $155
  • vs. Medicare Baseline: 3.20x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Cleveland Clinic is $93. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.20x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.
Cash / Self-Pay
$155

Average discount available for prompt cash payment at this facility.

Insurance Median
$93

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: $155 (533%)
Insurance Median: $93 (320%)
Cash: $155 (533% of Medicare)
Ins. Median: $93 (320% 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 320% of the Medicare baseline (a markup of 220%). 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
UnitedHealthcare $16 - $160 55%
Paramount $17 - $91 58%
Buckeye $18 - $93 62%
Caresource $18 - $89 62%
Summacare $18 - $114 62%
United $18 - $163 62%
Amerihealth $19 65%
Molina $19 - $93 65%
Aetna $28 - $239 96%
Blue Cross Blue Shield $28 - $203 96%
Cigna $28 - $191 96%
Devoted Health $28 - $37 96%
Humana $28 - $203 96%
The Health Plan $28 - $143 96%
Upmc $28 - $143 96%
Valor $28 - $37 96%
Communicare $29 - $39 100%
Perennial Health $30 - $40 103%
Pphp $30 103%
Zing Health $30 - $72 103%
Mmo $37 - $139 127%
Cc Ehp $52 - $149 179%
Oscar $52 - $92 179%
Ohcp $75 - $116 258%
Ohio Healthy $78 - $167 268%
Aultcare $83 - $117 286%
Amish Community Aid Plan $87 - $120 299%
Omas $97 - $120 334%
United Bh $98 337%
Healthsmart $107 - $131 368%
Phphi $116 - $143 399%
Clarity Health $126 - $155 434%
Gms $136 - $167 468%
Quality Care Partners $136 - $167 468%
Php $143 492%
Consociate Health $146 - $179 502%
Medical Benefit Corp $167 575%
Parkview Health Plan $167 575%
Multiplan $175 - $215 602%
Three Rivers $175 - $215 602%
Usa Managed Care $175 602%
Community Health Alliance $191 657%
Frontpath $215 740%
Managed Care Services $215 740%
Tertiary Care Network $215 740%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9500 Euclid Avenue, Cleveland, OH 44195
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals