CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: El Centro Regional Medical Center

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $119
  • Cash Discount Price: $104
  • vs. Medicare Baseline: 4.29x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at El Centro Regional Medical Center is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $104. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 4.29x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.
Cash / Self-Pay
$104

Average discount available for prompt cash payment at this facility.

Insurance Median
$119

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $104 (375%)
Insurance Median: $119 (429%)
Cash: $104 (375% of Medicare)
Ins. Median: $119 (429% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 429% of the Medicare baseline (a markup of 329%). 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
Blue Cross Blue Shield $29 - $254 105%
Brand New Day Comm - All Other Plans $29 105%
Brand New Day Mcr $29 105%
Healthnet Mcr Adv $29 105%
Molina Mcr Adv $29 105%
Scp Managed Care - All Plans $29 105%
Tricare $29 105%
UnitedHealthcare $29 - $79 105%
Easy Choice Mcr Adv-All Plans $32 115%
Healthnet Hmo $36 130%
Cdcr Correctional-All Plans $38 137%
Aetna $62 - $70 224%
Pacificare-All Plans $87 - $98 314%
Mulitplan Primary - All Other Plans $95 - $107 343%
Cigna $105 - $118 379%
Multiplan Comp $112 - $126 404%
Trident - All Plans $119 - $134 429%
Healthnet Comm-All Other Plans $126 - $142 455%
Humana $130 - $147 469%
Ahccs/Medi-Cal Misc - All Plans $140 - $158 505%
Brand New Day Mcal $140 - $158 505%
Medi-Cal $140 - $158 505%
Molina Exchange - All Other Plans $140 - $158 505%
Ambetter / Centene $144 - $163 519%
Molina Mcal $154 - $174 556%
Blue Shield-All Plans $338 1219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1415 Ross Avenue, El Centro, CA 92243
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals