CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Tristar Southern Hills Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $28
  • Cash Discount Price: $581
  • vs. Medicare Baseline: 0.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Tristar Southern Hills Medical Center is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $581. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.
Cash / Self-Pay
$581

Average discount available for prompt cash payment at this facility.

Insurance Median
$28

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: $581 (1999%)
Insurance Median: $28 (96%)
Cash: $581 (1999% of Medicare)
Ins. Median: $28 (96% 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
Wellpoint $18 - $20 62%
Amerigroup $24 - $28 83%
Devoted Health Plan $24 - $28 83%
Healthspring $24 - $28 83%
Humana $24 - $145 83%
Odyssey Healthcare $24 - $28 83%
Sarah Cannon Research $24 - $28 83%
United $24 - $261 83%
Aetna $25 - $326 86%
Blue Cross Blue Shield $25 - $59 86%
Wellcare $25 - $28 86%
Zing $25 - $28 86%
American Health Advantage $26 - $29 89%
Evergreen Hmo $26 - $29 89%
Signature Advantage $26 - $29 89%
Atrio Golden Times $27 - $30 93%
Bright Health $28 - $139 96%
Prime Health $35 - $511 120%
Corvel Corporation $36 - $41 124%
Novanet $36 - $41 124%
Oscar $106 365%
Kentucky Labor Cabinet $107 368%
Apex Health $110 379%
Nhc Advantage, Inc. $110 379%
Pruitt Health (Allyalign) $110 379%
Ambetter / Centene $130 - $135 447%
Cigna $146 - $189 502%
Bgfh Singlesource $290 - $494 998%
Multiplan $337 1160%
Employers Health Network $407 1401%
Odom'S Tn Pride Sausage $436 1500%
Beech Street $511 1758%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 391 Wallace Rd, Nashville, TN 37211
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals