CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: University Hospitals Avon Rehabilitation Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $115
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 3.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at University Hospitals Avon Rehabilitation Hospital is $115. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.96x the Medicare baseline. Located in 37900 Chester Rd, Avon, OH.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$115

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: $115 (396%)
Insurance Median: $115 (396%)
Cash: $115 (396% of Medicare)
Ins. Median: $115 (396% 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 396% of the Medicare baseline (a markup of 296%). 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
Uh Employees (Administered By Meritian) $44 - $54 151%
Blue Cross Blue Shield $64 - $140 220%
Healthsmart (Formerly Emerald) $73 - $91 251%
Ohio Health Choice - Preferred Choice Plus $73 - $91 251%
Clarity Health (Enterprise Group Planning Will Be Listed On Id Card As Well) $83 - $103 286%
Occunet Fka Health Ohio Network $83 - $103 286%
Paramount $84 - $140 289%
Ohio Preferred Network $90 - $112 310%
First Health $95 - $119 327%
Beechstreet $101 - $126 348%
Fortified $101 - $126 348%
Multiplan $101 - $126 348%
Ohio Health Choice $101 - $126 348%
Phcs $101 - $126 348%
Aetna $112 - $140 385%
Ambetter / Centene $112 - $140 385%
Amerihealth Cartias $112 - $140 385%
Antidote Healthe Care Of Ohio $112 - $140 385%
Aultcare $112 - $140 385%
Buckeye $112 - $140 385%
Caresource $112 - $140 385%
Caresource (Marketplace) $112 - $140 385%
Cigna $112 - $140 385%
Devoted $112 - $140 385%
Health Plan $112 - $140 385%
Humana $112 - $140 385%
Jp Farley (Select Employers) $112 - $140 385%
Medical Mutual $112 - $140 385%
Medical Mutual (Supermed, Trad, Medflex) $112 - $140 385%
Medical Mutual (Marketplace Plan) $112 - $140 385%
Molina $112 - $140 385%
Summacare $112 - $140 385%
United $112 - $140 385%
UnitedHealthcare $112 - $140 385%
Wellcare $112 - $140 385%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 37900 Chester Rd, Avon, OH 44011
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL