CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Sharp Coronado Hospital and Hlthcr Ctr

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $121
Cash Discount Price: $164
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Sharp Coronado Hospital and Hlthcr Ctr is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.16x the Medicare baseline. Located in 250 Prospect Place, Coronado, CA.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $164 (564%)

Insurance Median: $121 (416%)

Cash: $164 (564% of Medicare)

Ins. Median: $121 (416% 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 416% of the Medicare baseline (a markup of 316%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Aetna	$14 - $164	48%
Humana	$26 - $65	89%
Blue Cross Blue Shield	$33 - $196	114%
Community Health Group	$33 - $164	114%
Medi-Cal	$33 - $65	114%
Molina	$38 - $164	131%
Cigna	$61 - $133	210%
UnitedHealthcare	$61 - $174	210%
Blue Shield	$65 - $153	224%
Interplan	$74 - $87	255%
Managed Health Network	$74 - $164	255%
Multiplan	$74 - $214	255%
San Diego Pace	$87	299%
Health Net	$101 - $214	348%
California Health And Wellness	$105 - $174	361%
County Medical Services	$121 - $153	416%
Indian Health Council	$138	475%
Allianz Global Assistance	$146 - $214	502%
Epic Americas	$150 - $153	516%
Medicare (plans)	$164	564%

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 $164.
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 Sharp Coronado Hospital and Hlthcr Ctr 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.