CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: St Mary Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $54
  • Cash Discount Price: $1,268
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at St Mary Medical Center is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,268. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.86x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.
Cash / Self-Pay
$1,268

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $1,268 (4363%)
Insurance Median: $54 (186%)
Cash: $1,268 (4363% of Medicare)
Ins. Median: $54 (186% 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
Medicaid / KanCare $10 - $48 34%
Aetna $12 - $174 41%
UnitedHealthcare $14 - $104 48%
Keystone First $20 - $40 69%
Keystone First Chip $20 - $40 69%
Pace-Trinity Health $25 86%
Blue Cross Blue Shield $30 - $247 103%
Cigna $30 - $358 103%
Align Senior Care $31 107%
Medicare (plans) $31 - $54 107%
Health America Advantra $36 124%
Ambetter / Centene $54 186%
Oscar $54 186%
Prime Healthcare $54 186%
Jefferson Health Plan Commercial $55 189%
Homestead Health Plans Woods Center $59 203%
Group Pension Administrators $68 234%
Reedman Toll $68 234%
Blue Shield - Pa (Highmark) $81 279%
Geha $103 354%
Amerihealth $124 - $247 427%
Blue Shield - Ca $124 - $247 427%
Blue Shield - Id (Regence) $124 - $247 427%
Blue Shield - Ny Highmark Western $124 - $247 427%
Blue Shield - Wa (Regence) $124 - $247 427%
Meritain $174 599%
Multiplan $176 606%
Prime Health Services $176 606%
Galaxy Health Network $185 637%
Three Rivers Provider Network $185 637%
Upmc Health Plan $358 1232%
Webtpa $358 1232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Langhorne-Newtown Rd, Langhorne, PA 19047
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals