CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: St David's South Austin Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $41
  • Cash Discount Price: $145
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at St David's South Austin Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.41x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$145

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $145 (499%)
Insurance Median: $41 (141%)
Cash: $145 (499% of Medicare)
Ins. Median: $41 (141% 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
Superior Health Plan $6 - $31 21%
Oscar $21 - $36 72%
Wellmed $25 - $29 86%
Aetna $26 - $181 89%
Blue Cross Blue Shield $26 - $180 89%
Cigna $26 - $48 89%
Devoted Health $26 - $30 89%
Harbor Hospice $26 - $30 89%
Humana $26 - $30 89%
Moda $26 - $39 89%
Odyssey Hospice $26 - $30 89%
St David’S Hospice $26 - $30 89%
Triwest Veterans $26 - $30 89%
United $27 - $75 93%
American Health Plan Of Texas $28 - $31 96%
Provider Partners Health Plan $28 - $32 96%
Pyramid Life $28 - $32 96%
Shared Health $28 - $31 96%
Texas Independent Health Plan $28 - $32 96%
Wellcare $28 - $32 96%
Imperial Insurance $29 - $33 100%
Molina Healthcare $29 - $33 100%
Triwest Health Alliance $29 100%
Covenant Management Systems $32 - $48 110%
Healthcare Highways $32 - $50 110%
Universal Health $32 - $36 110%
Austin Fc $33 - $37 114%
Imo Med - Select Network $33 - $50 114%
Amerigroup $34 117%
Sendero $35 - $51 120%
Moda Health $40 - $62 138%
Naphcare $41 - $46 141%
Seven Corners $41 - $46 141%
Texas Healthcare Foundation Heb $41 - $62 141%
Texas Workforce Commission $43 - $65 148%
Averde Health $50 - $75 172%
Corvel Corporation $52 - $59 179%
Comanche County $56 - $84 193%
Emerging Therapy Solutions $56 - $115 193%
National Choicecare $56 - $84 193%
Healthsmart Preferred Care $61 - $134 210%
Independent Medical Systems $61 - $92 210%
Physicians Cooperative Of Texas $61 - $92 210%
UnitedHealthcare $66 - $167 227%
Prime Health $67 - $100 231%
First Health $70 - $120 241%
Coastal Comp Health Networks $72 - $109 248%
National Health Care $72 - $109 248%
Occunet $78 - $117 268%
Texas Municipal League $78 - $117 268%
Medcorp Southwest $83 - $125 286%
Rockport Healthcare Group $89 - $150 306%
Bce Emergis Corporation $100 - $150 344%
Beech Street $100 - $150 344%
Medical Control Network Solutions $100 - $150 344%
Multiplan $100 - $150 344%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals