CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Carnegie Tri-County Municipal Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $72
Cash Discount Price: $49
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Carnegie Tri-County Municipal Hospital is $72. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.48x the Medicare baseline. Located in 102 North Broadway, Carnegie, OK.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$72

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: $49 (169%)

Insurance Median: $72 (248%)

Cash: $49 (169% of Medicare)

Ins. Median: $72 (248% 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 248% of the Medicare baseline (a markup of 148%). 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
Aetna	$20 - $141	69%
Blue Cross Blue Shield	$38 - $120	131%
Global Health Mcr Adv	$38 - $75	131%
Humana	$38 - $141	131%
UnitedHealthcare	$38 - $75	131%
Wellcare Mcr Adv - All Plans	$38 - $75	131%
Ambetter / Centene	$50 - $97	172%
Health Choice - All Plans	$50	172%
Community Care Comm Ip/Op Only - All Plans	$58 - $113	200%
Preferred Comm Ppo - All Plans	$58 - $113	200%
Global Health Ip/Op Only - All Other Plans	$61 - $120	210%
First Health - All Plans	$65 - $127	224%
Multiplan - All Plans	$66 - $130	227%
Soonerselect Mcaid - All Plans	$72 - $141	248%

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 $49.
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 Carnegie Tri-County Municipal Hospital 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.