CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Preston Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $106
  • Cash Discount Price: $73
  • vs. Medicare Baseline: 3.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Preston Memorial Hospital is $106. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.65x the Medicare baseline. Located in 150 Memorial Drive, Kingwood, WV.
Cash / Self-Pay
$73

Average discount available for prompt cash payment at this facility.

Insurance Median
$106

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: $73 (251%)
Insurance Median: $106 (365%)
Cash: $73 (251% of Medicare)
Ins. Median: $106 (365% 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 365% of the Medicare baseline (a markup of 265%). 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
Advantra $87 - $88 299%
Aetna $87 - $132 299%
Humana $87 - $88 299%
Medicare (plans) $87 - $118 299%
Uhc_Va $87 - $88 299%
Upmc $91 - $92 313%
Medicaid / KanCare $94 - $100 323%
Unicare $103 354%
Blue_Cross_Highmark_Aca $105 - $106 361%
Blue_Cross_Highmark_Pos $117 - $118 403%
Blue_Cross_Highmark_Ppo $117 - $118 403%
Blue_Cross_Highmark_Traditional $128 - $130 440%
UnitedHealthcare $130 - $132 447%
Cigna $133 - $135 458%
Geha $137 - $139 471%
4_Most $140 - $142 482%
Health $140 - $142 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 150 Memorial Drive, Kingwood, WV 26537
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals