CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $64
  • Cash Discount Price: $165
  • vs. Medicare Baseline: 2.20x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Independence Health System Butler Memorial Hospita is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.20x the Medicare baseline. Located in One Hospital Way, Butler, PA.
Cash / Self-Pay
$165

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $165 (568%)
Insurance Median: $64 (220%)
Cash: $165 (568% of Medicare)
Ins. Median: $64 (220% 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 220% of the Medicare baseline (a markup of 120%). 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
Upmc $16 - $248 55%
Highmark $27 - $59 93%
Life Butler County $28 96%
Martin'S Point - Usfhp $28 - $83 96%
Medicare (plans) $28 96%
Peak Health $28 - $165 96%
Provider Partners $28 96%
Tricare $28 96%
UnitedHealthcare $28 - $31 96%
Aetna $29 - $189 100%
Amerihealth $29 100%
Devoted Health Plan $29 - $94 100%
Geisinger $29 - $236 100%
Humana $29 100%
The Health Plan $29 - $65 100%
Gateway $30 - $248 103%
Pa Health & Wellness $30 103%
American Health Plan $31 107%
Pnoa $31 - $189 107%
Highmark Aca - Direct Blue $37 - $44 127%
Highmark - Ind.& Managed Care $44 - $65 151%
Highmark Community Blue $44 - $57 151%
Workers Comp $47 162%
Ellwood Group $56 - $101 193%
Ccbh - Behavioral Health $64 - $118 220%
Cigna $69 - $118 237%
Private Healthcare Systems $165 - $201 568%
Devon $177 609%
Intergroup $189 650%
Multiplan $212 730%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Way, Butler, PA 16001
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals