CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Adventist Health Ukiah Valley

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $156
Cash Discount Price: $41
vs. Medicare Baseline: 5.37x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Adventist Health Ukiah Valley is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.37x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $41 (141%)

Insurance Median: $156 (537%)

Cash: $41 (141% of Medicare)

Ins. Median: $156 (537% 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 537% of the Medicare baseline (a markup of 437%). 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
Kaiser Medi-Cal	$11 - $16	38%
Medi-Cal	$11 - $16	38%
Aetna	$22 - $142	76%
Blue Shield Mcr Adv	$30	103%
Kaiser Mcr Adv	$30	103%
Tricare	$30	103%
UnitedHealthcare	$30 - $185	103%
Ah Employee Health Plan - All Plans	$34 - $55	117%
Cigna	$38 - $172	131%
Blue Shield Epn-All Other Plans	$42 - $290	145%
Blue Shield Non-Epn	$44 - $297	151%
Healthnet-All Plans	$44 - $126	151%
Western Growers-All Plans	$44 - $309	151%
Mendocino Lcc District-All Plans	$51 - $144	175%
Kaiser-All Other Plans	$62 - $177	213%
Blue Cross Blue Shield	$66 - $634	227%
Three Rivers-All Plans	$70 - $199	241%
Foundation For Medical Care-All Plans	$153 - $166	526%
Networks By Design-All Plans	$163 - $177	561%
Phcs Multiplan-All Plans	$163 - $177	561%
Interplan-All Plans	$167 - $181	575%
Beech Street-All Plans	$173 - $188	595%
Choice Care-All Plans	$173 - $188	595%
Health Mgmt Network-All Plans	$173 - $188	595%

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 $41.
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 Adventist Health Ukiah Valley 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.