CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: UPMC Hamot

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $56
  • Cash Discount Price: $102
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at UPMC Hamot is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.93x the Medicare baseline. Located in 201 State Street, Erie, PA.
Cash / Self-Pay
$102

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $102 (351%)
Insurance Median: $56 (193%)
Cash: $102 (351% of Medicare)
Ins. Median: $56 (193% 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.

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
Upmc Health Plan $9 - $44 31%
Aetna $10 - $119 34%
UnitedHealthcare $10 - $139 34%
Geisinger $12 41%
Highmark Wholecare (Prev Gateway) $12 - $85 41%
Amerihealth Caritas $13 45%
Health Partners Plans (Jefferson Health Plan) $13 45%
Pa Health & Wellness $14 48%
Blue Cross Blue Shield $25 - $123 86%
Univera $26 - $75 89%
Fidelis $38 - $84 131%
Independent Health $46 - $51 158%
Upmc Work Partners $47 162%
Cigna $51 - $68 175%
Molina Healthcare Of Ny $84 289%
Intergroup $110 - $136 379%
Multiplan $119 - $136 409%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals