CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: El Centro Regional Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $122
  • Cash Discount Price: $132
  • vs. Medicare Baseline: 4.20x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at El Centro Regional Medical Center is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.20x the Medicare baseline. Located in 1415 Ross Avenue, El Centro, CA.
Cash / Self-Pay
$132

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $132 (454%)
Insurance Median: $122 (420%)
Cash: $132 (454% of Medicare)
Ins. Median: $122 (420% 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 420% of the Medicare baseline (a markup of 320%). 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 $30 - $254 103%
Brand New Day Comm - All Other Plans $30 103%
Brand New Day Mcr $30 103%
Healthnet Mcr Adv $30 103%
Molina Mcr Adv $30 103%
Scp Managed Care - All Plans $30 103%
Tricare $30 103%
UnitedHealthcare $30 - $94 103%
Easy Choice Mcr Adv-All Plans $34 117%
Healthnet Hmo $38 131%
Cdcr Correctional-All Plans $40 138%
Aetna $83 286%
Pacificare-All Plans $117 403%
Mulitplan Primary - All Other Plans $128 440%
Cigna $141 485%
Multiplan Comp $150 516%
Trident - All Plans $160 551%
Healthnet Comm-All Other Plans $169 582%
Humana $175 602%
Ahccs/Medi-Cal Misc - All Plans $188 647%
Brand New Day Mcal $188 647%
Medi-Cal $188 647%
Molina Exchange - All Other Plans $188 647%
Ambetter / Centene $194 668%
Molina Mcal $207 712%
Blue Shield-All Plans $338 1163%

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