CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $182
  • Cash Discount Price: $455
  • vs. Medicare Baseline: 6.26x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Hospital of Univ of Pennsylvania is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $455. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 6.26x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$455

Average discount available for prompt cash payment at this facility.

Insurance Median
$182

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: $455 (1566%)
Insurance Median: $182 (626%)
Cash: $455 (1566% of Medicare)
Ins. Median: $182 (626% 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 626% of the Medicare baseline (a markup of 526%). 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
Gspp And Wissahickon Hospice $15 52%
UnitedHealthcare $17 - $455 58%
Health Partners $20 - $455 69%
Blue Cross Blue Shield $30 - $455 103%
Kaiser Permanente $30 - $455 103%
Medicare (plans) $30 - $31 103%
Philadelphia Va Medical Center $30 103%
Tricare $30 103%
Upmc $30 - $455 103%
Us Family Health Plan $30 103%
Cigna $31 - $205 107%
Devoted Health $31 107%
Geisinger Health Plan $31 - $95 107%
Humana $31 - $364 107%
Ibc $31 107%
Pa Health And Wellness $31 - $49 107%
Penn Life (Living Independently For Elders) $31 107%
Aetna $32 - $455 110%
Clover Health Plan $32 110%
Keystone First $33 114%
Gateway Health Plan $37 127%
Elap $42 145%
Claims Watcher $48 - $54 165%
Oscar Health Plan $51 175%
Centivo $54 186%
Elap Services $56 193%
Highmark $63 217%
Paired Kidney Exchange $73 251%
Horizon Nj Health $77 - $80 265%
Penn Global Medicine $79 272%
Keystone Mercy Health Plan $91 - $455 313%
Preferred Health Care Eliance $100 344%
Pgm - Regie De L'Assurance Maladie Quebec $105 361%
Pgm - Kuwait Defense $159 - $205 547%
Qualcare $173 595%
Olympus $179 616%
Coventry $182 - $232 626%
Medicaid / KanCare $182 - $455 626%
Pgm - Chop $182 626%
Wissahickon Hospice $182 626%
Healthamerica/Coventry $205 - $223 705%
Ibc Commercial Hpn $205 705%
Keystone Hmo Proactive $210 723%
First Health Global $228 785%
Health Net $273 939%
Pgm - Royal Embassy Of Saudi Arabia $273 939%
Pgm - Embassy Of Qatar $296 1019%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $296 1019%
Interlink $305 1050%
Pgm - Embassy Of The United Emirates/Ipc $318 1094%
Health America/Ccn $364 1253%
Intergroup $364 1253%
Pgm - Kuwait Health Division $364 1253%
Pgm - Kuwait Oil $364 1253%
Preferred Care $364 1253%
Blue Quality Centers For Transplant (Bqct) $455 1566%
City Of Philadelphia Behavioral Health $455 1566%
Commercial Other $455 1566%
International Pfs $455 1566%
Pa Medical Assistance $455 1566%
United Behavioral Health $455 1566%
Workers Compensation $455 1566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals