CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: San Gorgonio Memorial Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $32
Cash Discount Price: $64
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at San Gorgonio Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $64 (220%)

Insurance Median: $32 (110%)

Cash: $64 (220% of Medicare)

Ins. Median: $32 (110% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Lasalle Medical Associates	$29	100%
Beaver Medical Group	$31	107%
Blue Cross Blue Shield	$31 - $111	107%
Blue Shield	$31 - $123	107%
Choice Physicians Network	$31	107%
Heritage Provider Network	$31	107%
Inland Empire Health Plan	$31 - $34	107%
Kaiser	$31 - $92	107%
Providence Health Network	$31	107%
Redlands Community Hospital	$31	107%
UnitedHealthcare	$31	107%
Easy Choice Health Plan	$32	110%
Epic Management	$32	110%
Health Net	$34 - $44	117%
Velocity	$34	117%
Imperial Health Plan	$35	120%
Cigna	$149 - $165	513%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $64.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm San Gorgonio Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.