CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Adventist Health Sonora

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $47
  • Cash Discount Price: $23
  • vs. Medicare Baseline: 1.62x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Adventist Health Sonora is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $23. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.62x the Medicare baseline. Located in 1000 Greenley Road, Sonora, CA.
Cash / Self-Pay
$23

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $23 (79%)
Insurance Median: $47 (162%)
Cash: $23 (79% of Medicare)
Ins. Median: $47 (162% 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
Bc Mcal $11 38%
Celtic Ca Hlth Well Mcal - All Plans $11 - $22 38%
Central Ca Alliance Mcal $11 - $18 38%
Healthnet Mcal $11 - $23 38%
Medi-Cal $11 - $16 38%
Central Ca Alliance Ccs Mcal $16 - $18 55%
Central Ca Alliance Comm Profee Only-All Other Pla $16 55%
Central Ca Alliance Chdp Mcal $18 - $22 62%
Aetna $30 - $140 103%
Blue Shield Mcare $30 103%
Central Ca Alliance Mcr Adv Profee Only $30 103%
Healthnet Mcr Adv $30 103%
Phs Prime Health Srvcs-All Plans $30 103%
Tricare $30 103%
UnitedHealthcare $30 - $170 103%
Ah Employee Health Plan - All Plans $34 - $55 117%
Cigna $37 - $188 127%
Greatwest Oa/Pos/Hmo $40 - $168 138%
Greatwest Ppo - All Other Plans $40 - $178 138%
Blue Shield Epn $42 - $150 145%
Western Growers/Pinnacle - All Plans $42 - $342 145%
Blue Shield - All Other Plans $44 - $150 151%
Healthnet - All Other Plans $44 - $173 151%
Bc Mcs $47 - $492 162%
Bc Non-Mcs - All Other Plans $47 - $409 162%
Beech Street- All Plans $70 - $168 241%
Trpn - Three Rivers Ppo - All Plans $70 - $158 241%
Kaiser - All Plans $99 341%
Affordable Health - All Plans $178 613%
Interplan - All Plans $178 613%
Multiplan - All Plans $178 613%
Phcs Ppo - All Plans $178 613%
Stanilaus Foundation - All Plans $188 647%
Bc Exchange $365 1256%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Greenley Road, Sonora, CA 95370
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals