CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: PAM Rehabilitation Hospital of Round Rock

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $59
Cash Discount Price: $112
vs. Medicare Baseline: 2.03x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at PAM Rehabilitation Hospital of Round Rock is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.03x the Medicare baseline. Located in 351 Seton Pkwy, Round Rock, TX.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $112 (385%)

Insurance Median: $59 (203%)

Cash: $112 (385% of Medicare)

Ins. Median: $59 (203% 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 203% of the Medicare baseline (a markup of 103%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Curative	$21	72%
Whole Foods (Employers Health Network)	$26	89%
Sendero Health Plan	$27 - $49	93%
Baylor Scott And White Health Plan	$28	96%
Blue Cross Blue Shield	$28 - $56	96%
Christus Health Plan	$28	96%
Humana	$28 - $169	96%
Ilumed Aco Reach	$28	96%
Wellcare Complete	$28	96%
Wellmed	$28	96%
Wellpoint (Amerigroup)	$28	96%
UnitedHealthcare	$29 - $110	100%
Aetna	$34 - $90	117%
Velocity Provider Ppo Network	$34 - $84	117%
Prime Health Services	$36 - $95	124%
Ninety Degree Benefits	$42	145%
Ambetter / Centene	$50	172%
Seton Health Plan	$56	193%
Healthcare Highways	$62	213%
Cigna	$70	241%
Oscar	$75 - $90	258%
Superior Health Plan	$75	258%
America'S Choice Provider	$78	268%
Quik Trip	$84	289%
Usa Managed Care Organization	$84	289%
Multiplan/Phcs	$90	310%
Provider Network Of America	$101	348%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $112.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Rehabilitation Hospital of Round Rock is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.