CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Licking Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $232
  • Cash Discount Price: $271
  • vs. Medicare Baseline: 7.98x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Licking Memorial Hospital is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $271. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 7.98x the Medicare baseline. Located in 1320 West Main Street, Newark, OH.
Cash / Self-Pay
$271

Average discount available for prompt cash payment at this facility.

Insurance Median
$232

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: $271 (933%)
Insurance Median: $232 (798%)
Cash: $271 (933% of Medicare)
Ins. Median: $232 (798% 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 798% of the Medicare baseline (a markup of 698%). 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
Aetna $27 - $270 93%
Blue Cross Blue Shield $27 - $281 93%
Champva [500001] $27 93%
Cigna $27 - $295 93%
Humana $27 - $318 93%
Medicare (plans) $27 93%
Tricare $27 93%
UnitedHealthcare $27 - $278 93%
Veterans Administration [100068] $27 93%
Wellcare By Allwell [450104] $27 93%
Molina Marketplace [100106] $44 151%
Medical Mutual [100114] $148 - $272 509%
Medben [700068] $189 - $321 650%
Benicomp [70090] $202 - $246 695%
Consociate Health 6 Degrees [100059] $216 - $262 743%
Consociate Health [100029] $216 - $262 743%
Allied Benefit Systems [100015] $221 - $268 760%
Geha [100039] $221 - $268 760%
Gravie Administrative Services [100165] $221 - $268 760%
Meritain [100063] $221 - $268 760%
Optima [700069] $221 - $268 760%
Trustmark Small Business Benefits [100263] $221 - $268 760%
Webtpa [100127] $221 - $268 760%
Healthscope [100157] $229 - $278 788%
Surest [100016] $229 - $278 788%
United Medical Resources [700071] $229 - $278 788%
American Postal Workers [100089] $243 - $295 836%
Antidote Health Plan Of Ohio [70006803] $243 - $295 836%
Coresource [100002] $243 - $327 836%
Great West Life [700064] $243 - $295 836%
National Association Of Letter Carriers [100067] $243 - $295 836%
Ohio Healthy Luminare Health [100264] $243 - $295 836%
Ohio Healthy [100255] $243 - $295 836%
Ohio Ppo Connect [70006801] $243 - $295 836%
Osu Prime Care [100254] $243 - $295 836%
Quality Care Partners [70006802] $243 - $295 836%
The Health Plan [100261] $243 - $295 836%
Wellfleet Group, Llc [100164] $243 - $295 836%
Coventry [100010] $249 - $302 857%
Pan American Life [700070] $249 - $302 857%
Ohio Health Choice [100109] $259 - $314 891%
Administrative Concepts [100006] $262 - $318 902%
Carefactor [100087] $262 - $318 902%
Philadelphia American Life [100260] $262 - $327 902%
Reliance Standard-Asrm [100258] $262 - $318 902%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1320 West Main Street, Newark, OH 43055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals