CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Lewisgale Hospital Pulaski

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $179
  • Cash Discount Price: $396
  • vs. Medicare Baseline: 6.16x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Lewisgale Hospital Pulaski is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $396. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 6.16x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.
Cash / Self-Pay
$396

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $396 (1363%)
Insurance Median: $179 (616%)
Cash: $396 (1363% of Medicare)
Ins. Median: $179 (616% 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 616% of the Medicare baseline (a markup of 516%). 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
Humana $21 - $30 72%
Triatlantic $24 83%
Aetna $26 - $179 89%
Devoted $26 - $30 89%
Good Samaritan Hospice $26 - $30 89%
Health Net $26 89%
Magellan $26 - $30 89%
Sentara Health $26 - $30 89%
United $26 - $179 89%
United Mine Workers $26 - $30 89%
Virginia Premier Health $26 - $30 89%
Blue Cross Blue Shield $27 - $30 93%
Cigna $27 - $31 93%
Clear Spring Health Plan $27 - $31 93%
Evernorth Behavioral Health $27 - $31 93%
Align Senior Care $28 - $32 96%
Pyramid Life $28 - $32 96%
Lifeworks $71 - $75 244%
Universal Healthcare Group $82 - $87 282%
Virginia Health Network $131 - $282 451%
Greenvbrier Sporting Club $224 - $238 771%
Corvel $269 - $286 926%
Richfield Nursing Center $280 - $298 964%
Richfield Retirement Community $280 - $298 964%
Multiplan $288 - $306 991%
Community Care Network $299 - $318 1029%
Graham-White Manufacturing $299 - $318 1029%
Occunet Workers Comp $299 - $318 1029%
One Health Plan $299 - $318 1029%
Patients Choice $329 - $349 1132%
4Most $337 - $357 1160%
American Postal Workers Union $337 - $357 1160%
Phcs $337 - $357 1160%
Star Transportation $337 - $357 1160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Lee Highway, Pulaski, VA 24301
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals