CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: AHMC Seton Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $40
  • Cash Discount Price: $169
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at AHMC Seton Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.38x the Medicare baseline. Located in 1900 Sullivan Avenue, Daly City, CA.
Cash / Self-Pay
$169

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $169 (582%)
Insurance Median: $40 (138%)
Cash: $169 (582% of Medicare)
Ins. Median: $40 (138% 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.

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
Medi-Cal $9 31%
San Francisco Health Plan $12 41%
Cmac $13 45%
Hill Physicians Medical Group Inc $13 - $42 45%
Kaiser $13 - $173 45%
San Mateo County/San Mateo County General Hospital $13 45%
Asian American Medical Group $15 - $45 52%
Health Plan Of San Mateo Healthworx $15 52%
North East Medical Services $15 - $35 52%
Blue Cross Blue Shield $16 - $160 55%
Brown And Toland Medical Group $16 - $45 55%
Jade Health Care Mg $16 - $36 55%
Health Plan Of San Mateo $18 62%
Veterans Administration (Va) $25 86%
Self Pay $32 - $72 110%
Athens Administrators $33 114%
Corvel Healthcare $33 114%
Multiplan/Bce Emergis $33 - $158 114%
Work Comp Other $33 114%
Aetna $35 - $142 120%
Blue Shield Of California $35 - $214 120%
Brand New Day $35 - $45 120%
Care Advantage $35 120%
Chinese Community Health Plan $35 - $106 120%
For Your Benefit $35 120%
Healthnet Seniority $35 120%
Humana $35 120%
Imperial Health Plan $35 120%
Medicare (plans) $35 120%
Pacificare $35 120%
Apcmg $36 - $54 124%
Canopy Health $36 - $65 124%
Covid-19 Uninsured Program $36 124%
Tricare $36 124%
UnitedHealthcare $36 - $796 124%
Easy Choice Hospital Services $37 127%
Central Health Plan $38 131%
Ahmc Health $45 155%
Knox-Keene Act $45 155%
Interplan Corporation $127 437%
Cigna $148 509%
Healthcare Foundation Of San Mateo $148 - $158 509%
Private Healthcare Sytems Inc $158 544%
The First Health Network $158 544%
Health Net $162 557%
Beech Street Corporation $169 582%
Choicecare Network $179 616%
Multiplan $179 616%
Mills Peninsula Health Services $190 654%
Indemnity $211 726%
Workers Compensation Federal $211 726%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1900 Sullivan Avenue, Daly City, CA 94015
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals