CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Graham Regional Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $117
  • Cash Discount Price: $218
  • vs. Medicare Baseline: 4.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Graham Regional Medical Center is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $218. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.03x the Medicare baseline. Located in 1301 Montgomery Road, Graham, TX.
Cash / Self-Pay
$218

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

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: $218 (750%)
Insurance Median: $117 (403%)
Cash: $218 (750% of Medicare)
Ins. Median: $117 (403% 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 403% of the Medicare baseline (a markup of 303%). 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
Amerigroup $44 - $87 151%
Choicecare Network $44 - $87 151%
Superior Healthplan $44 - $87 151%
Wellpoint $59 - $117 203%
Aetna $94 - $189 323%
Cigna $94 - $189 323%
Blue Cross Blue Shield $99 - $218 341%
Three Rivers Provider Network $123 - $247 423%
Health Advantage Network $131 - $261 451%
Healthsmart Preferred Care $131 - $261 451%
UnitedHealthcare $156 537%
Curative $254 - $508 874%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1301 Montgomery Road, Graham, TX 76450
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals