CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: The Medical Center of Southeast Texas

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $131
  • Cash Discount Price: $436
  • vs. Medicare Baseline: 4.51x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at The Medical Center of Southeast Texas is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.51x the Medicare baseline. Located in 2555 Jimmy Johnson Blvd, Port Arthur, TX.
Cash / Self-Pay
$436

Average discount available for prompt cash payment at this facility.

Insurance Median
$131

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: $436 (1500%)
Insurance Median: $131 (451%)
Cash: $436 (1500% of Medicare)
Ins. Median: $131 (451% 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 451% of the Medicare baseline (a markup of 351%). 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
Medicaid / KanCare $11 - $39 38%
Community Health Choice $23 - $34 79%
Medsolutions $25 86%
Amerigroup $27 - $61 93%
Healthspring $27 93%
Humana $27 - $213 93%
Medicare (plans) $27 93%
Provider Partners Health Plan $27 93%
Selectcare $27 93%
Superior Healthplan $27 - $50 93%
Tihp (Texas Independence Health Plan) $27 93%
UnitedHealthcare $27 - $131 93%
Caresact $28 96%
Employer Direct Healthcare $28 - $35 96%
Hospice $28 96%
Molina Healthcare $28 - $39 96%
Rice Land Hospice $28 96%
Texas Medical Management Partners $28 - $35 96%
Tricare $28 96%
Triwest $28 96%
Blue Cross Blue Shield $29 - $194 100%
Cccn Pro Advantage $29 100%
Wellcare Of Texas $29 100%
League Medical Concepts $30 103%
Wellpath $31 107%
Community Health Choice Uhrip $32 - $37 110%
Harbor Hospice $32 - $37 110%
Texas Childrens Health Plan $32 - $39 110%
Beacon Health $37 - $43 127%
Corporate Remedies $41 141%
Elap Services $54 186%
Texas Workers Compensation $56 193%
Self Pay Emergent $60 - $71 206%
Cigna $116 - $329 399%
Dept Of Assistive And Rehabilitative Services $201 - $235 692%
Aetna $233 - $310 802%
Iasis Employees $241 - $282 829%
Magellan Behavioral Health $241 - $282 829%
First Health $281 - $329 967%
Galaxy Health Network $281 - $329 967%
Private Healthcare Systems $281 - $329 967%
Texas Municipal League $281 - $329 967%
Healthsmart $301 - $353 1036%
Multiplan $321 - $376 1105%
Commercial Non-Contracted $402 - $470 1383%
Heart To Heart Hospice $402 - $470 1383%
Lifesynch $402 - $470 1383%
Mhnet $402 - $470 1383%
Self Pay - Mcd Pending 100 Percent $402 - $470 1383%
Single Case Agreement $402 - $470 1383%
United Behavioral Health $402 - $470 1383%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals