CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Mon Health Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $321
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 11.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Mon Health Medical Center is $321. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 11.05x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$321

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: $115 (396%)
Insurance Median: $321 (1105%)
Cash: $115 (396% of Medicare)
Ins. Median: $321 (1105% 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 1105% of the Medicare baseline (a markup of 1005%). 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
Gateway_Health_Plan $8 28%
Unison_Plan $8 28%
Zelis_Other_Plan $23 - $52 79%
Geha_Plan $24 - $447 83%
Aetna $27 - $368 93%
Blue Cross Blue Shield $27 - $136 93%
Health_South_Mountain_View_Plan $27 93%
Humana $27 - $415 93%
Medicare (plans) $27 93%
Paramount_Elite_Plan $27 93%
Uhc_Onenet_Ppo_Plan $27 - $447 93%
Uhc_Options_Ppo_Plan $27 - $428 93%
Uhc_Plan $27 - $415 93%
Uhc_Va_Plan $27 93%
Umwa_Plan $27 93%
Upmc__Plan $27 - $447 93%
Zelis_Group_Health_Plan $27 - $52 93%
Maryland_Physicians_Care_Plan $29 - $322 100%
The_Health_Plan_Peia_Plan $33 114%
Acpn_Plan $54 - $415 186%
Seven_Corners_Plan $55 189%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $85 - $368 292%
The_Health_Plan_Plan $345 - $396 1187%
Cigna $361 - $415 1242%
Mon_County_Commission_Plan $361 - $415 1242%
Health_Payors_Organization_Plan $369 - $424 1270%
Multiplan_Phcs_Plan $381 - $438 1311%
Mutual_Of_Omaha_Plan $381 - $438 1311%
Three_Rivers_Plan $389 - $447 1339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals