CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Rio Grande Regional Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $30
  • Cash Discount Price: $573
  • vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Rio Grande Regional Hospital is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $573. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.03x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$573

Average discount available for prompt cash payment at this facility.

Insurance Median
$30

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: $573 (1972%)
Insurance Median: $30 (103%)
Cash: $573 (1972% of Medicare)
Ins. Median: $30 (103% 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
Wellmed $24 - $28 83%
Aetna $25 - $29 86%
Allegian Health $25 - $28 86%
Blue Cross Blue Shield $25 - $258 86%
Cigna $25 - $28 86%
Humana $25 - $413 86%
Independent Medical System $25 - $28 86%
Triwest Healthcare Alliance $25 - $28 86%
United $25 - $258 86%
American Health Plan $26 - $30 89%
Physicians Health Choice $26 - $30 89%
Prominence Health $26 - $30 89%
Provider Partners Health Plan Of Texas $26 - $30 89%
Shared Health $26 - $30 89%
Superior Health Plan $26 - $40 89%
Molina $27 - $31 93%
Triwest Health Alliance $28 96%
Universal Health Care $30 - $34 103%
Superior $39 - $44 134%
Corvel Corporation $49 - $56 169%
Focus Healthcare $50 - $57 172%
Omni Healthcare $52 - $59 179%
Molina Healthcare $61 - $69 210%
Texas Workforce Commission $138 475%
Oscar $156 537%
Averde Health $189 650%
Healthsmart Preferred Care $247 - $487 850%
Texas Athletic Network $300 - $600 1032%
First Health $330 1136%
National Healthcare Solutions $344 1184%
Southwest Medical $344 1184%
Coastal Comp $373 1284%
Usa Managed Care $373 - $459 1284%
Ppo Next/ Medical Control $430 1480%
Beech Street $459 1579%
Multiplan $459 1579%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals