CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Riverside Community Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $31
  • Cash Discount Price: $618
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Riverside Community Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $618. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
$618

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $618 (2127%)
Insurance Median: $31 (107%)
Cash: $618 (2127% of Medicare)
Ins. Median: $31 (107% 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.

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
La Care Health $13 45%
Molina $13 45%
Brand New Day $14 - $31 48%
Inland Empire Health Plan $18 - $52 62%
Bristol Hospice $22 - $24 76%
Aetna $27 - $111 93%
Alignment Health Plan $27 - $31 93%
Blue Cross Blue Shield $27 - $31 93%
Care1St Health Plan $27 - $31 93%
Central Health Plan $27 - $31 93%
Clever Care Of Golden State $27 - $31 93%
Easy Choice Health Plan $27 - $31 93%
Heritage Provider Network $27 - $42 93%
Humana $27 - $31 93%
Redlands Community Hospital $27 - $31 93%
Riverside Medical Clinic $27 - $37 93%
Riverside Physician $27 - $31 93%
Scan Health Plan $27 - $31 93%
Triwest Healthcare Alliance $27 - $31 93%
United $27 - $163 93%
UnitedHealthcare $27 - $31 93%
Blue Shield $29 - $79 100%
Health Net $30 - $138 103%
Corvel Corporation $31 - $36 107%
Healthsmart $32 - $495 110%
Next $32 - $495 110%
Medcare Partners $93 320%
Bright Health $245 843%
First Health $272 - $556 936%
American Health System $278 957%
Multiplan $495 - $526 1703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals