CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Washington Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $246
  • Cash Discount Price: $232
  • vs. Medicare Baseline: 8.47x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Washington Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $232. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 8.47x the Medicare baseline. Located in 2000 Mowry Ave, Fremont, CA.
Cash / Self-Pay
$232

Average discount available for prompt cash payment at this facility.

Insurance Median
$246

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: $232 (798%)
Insurance Median: $246 (847%)
Cash: $232 (798% of Medicare)
Ins. Median: $246 (847% 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 847% of the Medicare baseline (a markup of 747%). 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
Kaiser Medi-Cal $16 55%
Medi-Cal $16 55%
Blue Cross Blue Shield $35 - $258 120%
Health Net Sr Plus Hmo $35 120%
Aetna $36 - $253 124%
Alameda Alliance Mcr Adv $36 124%
Blue Shield Mcr Adv $36 124%
Brand New Day Mcr Adv - All Plans $36 124%
Canopy Mcr Adv $36 124%
Central Hlth Mcr Adv - All Plans $36 124%
Humana $36 - $321 124%
Kaiser Mcr Adv $36 124%
On Lok Senior Health Services-All Plans $36 124%
Tricare $36 124%
UnitedHealthcare $36 - $309 124%
Va (Triwest Ccn)-All Plans $36 124%
Health Net/Healthy Family/Aim $71 244%
Alameda Alliance Ppo-All Other Plans $107 368%
Canopy-All Other Plans $182 626%
Blue Shield Eppo $188 647%
Kaiser - All Other Plans $193 664%
Healthnet Comm - All Other Plans $215 740%
Cigna $222 - $286 764%
Blue Shield Hmo $240 826%
Pacific Health Alliance Epo $250 860%
Standford Health Services-All Plans $250 860%
County Of Santa Clara-All Plans $268 922%
Blue Shield Ppo - All Other Plans $278 957%
Pacific Foundation Epo $286 984%
Corvel-All Plans $303 1043%
Interplan B-2 Ppo $303 1043%
Masonic Homes Ppo-All Plans $303 1043%
Multiplan Ppo-All Plans $303 1043%
Pacific Health Alliance Ppo-All Other Plans $303 1043%
Preferred Health Network-All Plans $303 1043%
Interplan B-4 Ppo-All Other Plans $314 1081%
Cna (Mailhandlers)-All Plans $321 1105%
First Health -All Plans $321 1105%
Pacific Foundation Ppo-All Other Plans $321 1105%
Phcs/Private Healthcare Systems-All Plans $321 1105%
Three Rivers Provider Network-All Plans $321 1105%
Beech Street-All Plans $339 1167%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Mowry Ave, Fremont, CA 94538
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals