CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: HCA Houston Healthcare West

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $42
  • Cash Discount Price: $665
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at HCA Houston Healthcare West is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $665. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.45x the Medicare baseline. Located in 12141 Richmond Ave, Houston, TX.
Cash / Self-Pay
$665

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $665 (2288%)
Insurance Median: $42 (145%)
Cash: $665 (2288% of Medicare)
Ins. Median: $42 (145% 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
Oscar $25 - $138 86%
Aetna $26 - $157 89%
Amerigroup $26 - $99 89%
Blue Cross Blue Shield $26 - $247 89%
Chc Harris Health $26 - $29 89%
Cigna $26 - $566 89%
Devoted Health $26 - $29 89%
Humana $26 - $295 89%
Integranet Amerigroup Ipa $26 - $30 89%
Kelsey Seybold $26 - $29 89%
Renaissance Ipa Radiology $26 - $29 89%
Triwest Healthcare Alliance $26 - $29 89%
United $26 - $318 89%
Van Lang Ipa $26 - $30 89%
Wellcare $26 - $30 89%
Wellmed $26 - $29 89%
American Health Plan $27 - $31 93%
Procare Advantage $27 - $31 93%
Provider Partners Health Plan Of Texas $27 - $31 93%
Shared Health $27 - $31 93%
Superior Health Plan $27 - $42 93%
Molina $28 - $32 96%
Christus (Usfhp) $29 100%
Triwest Health Alliance $29 100%
Universal Healthcare Group $31 - $35 107%
Verda Health Plan $33 - $38 114%
Community Health Choice $37 - $42 127%
Superior $37 - $45 127%
Corvel Corporation $51 - $58 175%
Omni Healthcare $54 - $61 186%
Molina Healthcare $55 - $63 189%
Community Health Choice Mcd $81 - $92 279%
Texas Childrens Health Plans $103 - $168 354%
Texas Workforce Commission $149 - $170 513%
Healthsmart Preferred Care $267 - $601 919%
Fidelis Securecare Of Tx $280 - $318 964%
Texas Athletic Network $300 - $600 1032%
Coventry National First Health $332 - $377 1142%
Physicians Cooperative Of Texas $342 - $389 1177%
Rockport Workers Comp $342 - $389 1177%
Independent Medical System $373 - $424 1284%
National Healthcare Solutions $373 - $424 1284%
Southwest Medical $373 - $424 1284%
Triumph $373 - $424 1284%
Coastal Comp $404 - $460 1390%
Multiplan $466 - $601 1604%
Physicians, Inc $529 - $601 1820%
Affiliated Ppo $560 - $636 1927%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12141 Richmond Ave, Houston, TX 77082
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals