CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Baptist Memorial Hospital Tipton

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $122
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Baptist Memorial Hospital Tipton is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.20x the Medicare baseline. Located in 1995 Highway 51 S, Covington, TN.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $49 (169%)
Insurance Median: $122 (420%)
Cash: $49 (169% of Medicare)
Ins. Median: $122 (420% 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 420% of the Medicare baseline (a markup of 320%). 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
Magnolia Tn $16 55%
Aetna $19 - $61 65%
Blue Cross Blue Shield $30 - $122 103%
Humana $58 200%
Ppo Holdings $78 268%
Magnolia Regional Health Center $82 282%
Multiplan $88 - $153 303%
Littler $102 351%
Molina $102 351%
Access Health Services $122 420%
Butler Snow $122 420%
UnitedHealthcare $122 420%
Oscar $130 447%
First Choice Health Plan Of Ms $143 492%
Mpcn $153 526%
Novasys $153 526%
Ppo Plus $173 595%
Qca $184 633%
Cigna $185 - $204 637%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1995 Highway 51 S, Covington, TN 38019
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals