CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Medical Center Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $68
Cash Discount Price: $100
vs. Medicare Baseline: 2.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Medical Center Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $100. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.34x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$100

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $100 (344%)

Insurance Median: $68 (234%)

Cash: $100 (344% of Medicare)

Ins. Median: $68 (234% 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 234% of the Medicare baseline (a markup of 134%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Corvel Wc	$20	69%
Medicaid / KanCare	$21 - $23	72%
Superior Chips	$21	72%
UnitedHealthcare	$24 - $160	83%
Aetna	$28 - $104	96%
Care Improvement Plus	$28	96%
Humana	$28	96%
Novitas Solutions	$28	96%
Triwest Va Ccn	$28	96%
Ambetter / Centene	$29	100%
Wellcare By Allwell	$29	100%
Group Resources	$34	117%
Blue Cross Blue Shield	$43 - $77	148%
Workers Comp	$57	196%
Health Select	$58 - $68	200%
90 Degree Benefits	$75 - $91	258%
State Comptroller	$78	268%
Healthsmart Preferred Care	$94 - $109	323%
Caprock	$100 - $117	344%
Texas Mutual Wc	$104	358%
Firstcare	$110	379%
Geha	$147	506%
Cigna	$218	750%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $100.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Medical Center Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.