CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Uva Health Culpeper Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $84
  • Cash Discount Price: $103
  • vs. Medicare Baseline: 2.89x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Uva Health Culpeper Medical Center is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $103. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.89x the Medicare baseline. Located in 501 Sunset Lane, Culpeper, VA.
Cash / Self-Pay
$103

Average discount available for prompt cash payment at this facility.

Insurance Median
$84

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: $103 (354%)
Insurance Median: $84 (289%)
Cash: $103 (354% of Medicare)
Ins. Median: $84 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Blue Ridge Pace [10510] $26 89%
Medicaid / KanCare $26 89%
Veterans [99909] $27 93%
Aetna $29 - $182 100%
Blue Cross Blue Shield $29 100%
Champva [50002] $29 - $30 100%
Cigna $29 - $360 100%
HMO Part B [10099] $29 100%
Humana $29 100%
Medicare (plans) $29 100%
Tricare $29 - $30 100%
UnitedHealthcare $29 - $282 100%
VA Ccn [99926] $29 100%
VA Ccn [99927] $29 100%
Veterans Administration [99910] $29 100%
Carefirst [30007] $59 - $63 203%
Sentara [40021] $64 - $143 220%
Sentara Behavioral Health [40052] $65 - $143 224%
Beacon Health Options [40012] $96 330%
Commercial Contracted Hb Only [40056] $100 344%
Commercial Generic [40000] $100 - $134 344%
Geha [40009] $111 - $228 382%
Commercial Contracted Tpa [40055] $115 - $134 396%
Umwa [40037] $134 461%
Multiplan Generic [40035] $140 - $162 482%
Vhn Generic [40040] $140 - $162 482%
Healthsmart [40013] $143 492%
First Health Generic [40033] $157 540%
Gateway Health Alliance [40034] $162 557%
Kaiser Permenente [40014] $166 571%
Onenet Workers Comp Generic [60010] $167 575%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 501 Sunset Lane, Culpeper, VA 22701
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals