CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Clarion Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $50
  • Cash Discount Price: $87
  • vs. Medicare Baseline: 1.72x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Clarion Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $87. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.72x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$87

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $87 (299%)
Insurance Median: $50 (172%)
Cash: $87 (299% of Medicare)
Ins. Median: $50 (172% 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 $9 - $118 31%
Highmark $26 - $80 89%
Highmark - Ind.& Managed Care $26 - $80 89%
Martin'S Point - Usfhp $27 - $83 93%
Amerihealth $28 96%
Cigna $28 - $118 96%
Gateway $28 - $87 96%
Highmark Community Blue $28 96%
Medicare (plans) $28 96%
Tricare $28 96%
UnitedHealthcare $28 96%
Aetna $29 - $210 100%
Devoted Health Plan $29 - $94 100%
Geisinger $29 100%
The Health Plan $29 - $65 100%
Pa Health & Wellness $30 103%
American Health Plan $31 107%
Workers Comp $45 - $155 155%
Peak Health $53 - $165 182%
Devon $57 - $177 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals