CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Primary Children's Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $95
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 3.27x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Primary Children's Hospital is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.27x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$95

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: $99 (341%)
Insurance Median: $95 (327%)
Cash: $99 (341% of Medicare)
Ins. Median: $95 (327% 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 327% of the Medicare baseline (a markup of 227%). 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
Health Plan Of Nevada $24 - $29 83%
Healthy U $28 - $29 96%
Molina $28 - $112 96%
Selecthealth $28 - $112 96%
Southwest Behavioral Health $28 - $29 96%
Tricare $28 96%
Triwest $28 96%
UnitedHealthcare $28 - $112 96%
American Health $29 - $76 100%
Donor Connect $44 - $53 151%
Aetna $87 - $113 299%
Awh Connected $87 - $113 299%
Byu Athletics $87 - $112 299%
Campbell Scientific $87 - $112 299%
Cigna $87 - $112 299%
Deseret Mutual $87 - $112 299%
Emi $87 - $112 299%
Emi Health $87 - $112 299%
First Choice $87 - $112 299%
First Choice Of The Midwest $87 - $112 299%
Franklin County $87 - $112 299%
Global Excel $87 - $112 299%
Health Utah $87 - $112 299%
Humana $87 - $112 299%
Hygeia Corporation $87 - $112 299%
Ifit $87 - $112 299%
Juniper Systems $87 - $112 299%
Lw Miller $87 - $112 299%
Managed Care Admin $87 - $112 299%
Medcare International $87 - $112 299%
Motivhealth $87 - $112 299%
Pehp $87 - $112 299%
Prodegi Corp Benefit $87 - $112 299%
Tanner Llc $87 - $112 299%
Uofu $87 - $112 299%
Utah Tech $87 - $112 299%
Wise Network $87 - $112 299%
First Health $89 - $113 306%
Blue Cross Blue Shield $90 - $115 310%
Springtide $90 - $115 310%
Utah Behavioral Health Network $100 - $108 344%
Altius Mhnet Behavioral Health $108 - $117 372%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens