CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Saint Agnes Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $123
  • Cash Discount Price: $51,611
  • vs. Medicare Baseline: 4.23x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Saint Agnes Medical Center is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51,611. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.23x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.
Cash / Self-Pay
$51,611

Average discount available for prompt cash payment at this facility.

Insurance Median
$123

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: $51,611 (177602%)
Insurance Median: $123 (423%)
Cash: $51,611 (177602% of Medicare)
Ins. Median: $123 (423% 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 423% of the Medicare baseline (a markup of 323%). 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
Correctcare Integrated Health $19 65%
Medi-Cal Healthnet $21 - $24 72%
Blue Cross Blue Shield $22 - $34,240 76%
Aetna $30 - $16,182 103%
Humana $30 - $17,008 103%
Medicare (plans) $30 - $17,008 103%
UnitedHealthcare $31 - $17,082 107%
Welbe Health $32 - $16,992 110%
Align Senior Care $35 - $18,990 120%
Kaiser Permanente $54 - $28,897 186%
Advantek Central Usd $69 - $34,240 237%
Blue Shield - Ca $74 - $358 255%
Meritain $101 348%
Trustmark Small Business Benefits $101 348%
St Agnes Nicu Valley Childrens Hospital $105 361%
Allied Benefit Systems $106 365%
Boon Chapman $106 365%
Hap $106 365%
Webtpa $106 365%
Healthnet $110 - $132 379%
Coventry $111 382%
Cba Network By Design $122 420%
Network Health $122 420%
Allegiance $125 430%
American Postal Workers Secondary $125 430%
Cigna $125 430%
Multiplan $136 468%
Phcs $136 468%
Interplan $146 502%
Blue Benefit Administrators Of Massachusetts $358 1232%
Blue Care Network $358 1232%
Blue Distinction Transplant $358 1232%
Blue Shield - Id (Regence) $358 1232%
Blue Shield - Ny Highmark Northeastern $358 1232%
Blue Shield - Ny Highmark Western $358 1232%
Blue Shield - Pa (Highmark) $358 1232%
Blue Shield - Wa (Regence) $358 1232%
Geha $558 - $17,082 1920%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1303 E Herndon Ave, Fresno, CA 93720
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals