Physical therapy (therapeutic exercise)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 97110 (CPT)
- CPT Billing Code: 97110
- Insurance Median: $28
- Cash Discount Price: $30
- vs. Medicare Baseline: 0.96x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicaid / KanCare | $26 - $29 | 89% |
| Va | $27 | 93% |
| Humana | $27 - $28 | 93% |
| Medicare (plans) | $27 - $28 | 93% |
| UnitedHealthcare | $28 - $77 | 96% |
| Aetna | $29 | 100% |
| Providrs Care | $36 | 124% |
| Smarthealth | $38 | 131% |
| Ambetter / Centene | $46 | 158% |
| Blue Cross Blue Shield | $62 - $65 | 213% |
Consumer Guidance & Cost Commentary
For this physical therapy session, the facility's cash price of $30.00 is significantly lower than the negotiated rates charged to most insurance payers, which range from $26 to $77 depending on the plan. While the facility's cash rate is higher than the state average of $29.06 for Medicare, it remains the most affordable option for patients without insurance or those with high-deductible plans where the insurance allowed amount might exceed the cash price. Because commercial insurance contracts often include administrative overhead that inflates the baseline price, paying out-of-pocket can sometimes result in substantial savings compared to the final bill after insurance processing.
To maximize your potential savings, we recommend asking the hospital about "prompt-pay" discounts before scheduling your visit, as these upfront fee reductions can lower the total cost by 20% to 50%. If you choose to use insurance, be aware that the facility's negotiated rates vary widely, with UnitedHealthcare plans potentially facing rates as high as $77, while Medicaid and VA plans are covered at the lower end of the spectrum. Always verify your specific plan's allowed amount and check for any "self-pay" or "prompt-pay" incentives directly with the billing department to ensure you are not paying the full negotiated rate when a lower cash alternative is available.