CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Gifford Medical Center

Billing Code: 97110 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$49

about 1.7× the $29 Medicare rate · typically $20–$60

modeled estimate · not a bill or quote

Medicare pays $29 Fair price $49 Cash price $17 Hospital's list price $33

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$15 - $126	52%
Blue Cross Blue Shieldmajor	$5 - $119	17%
Aetnamajor	$31 - $126	107%
Cignamajor	$26 - $106	89%
Harvard Pilgrim	$26 - $106	89%
MVP Health Care	$15 - $113	52%
+ 1 smaller / regional plan	$15 - $60

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 17), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 97110.

Insurance Before you use insurance

Call your insurance company to confirm Gifford Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 97110.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Gifford Medical Center

Compare: Physical therapy (therapeutic exercise) at other VT hospitals

Insurance negotiated median for the same procedure, sorted lowest first.