CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Adventist Health Lodi Memorial

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $39
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Adventist Health Lodi Memorial is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.34x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $15 (52%)
Insurance Median: $39 (134%)
Cash: $15 (52% of Medicare)
Ins. Median: $39 (134% 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 $6 - $22 21%
Celtic Ins Company - All Plans $6 - $18 21%
Kaiser Mcal $6 - $16 21%
Medi-Cal $6 - $16 21%
Hp Mcal Pro Fee $7 24%
Healthnet Mcal $8 - $22 28%
Hp Of San Joaquin Mcal $8 - $20 28%
Medcore(Omni Ipa) Op Only- All Plans $20 - $88 69%
Blue Shield Epn - All Other Plans $25 - $110 86%
Blue Shield Non-Epn $26 - $114 89%
Aetna $27 - $97 93%
Alignment Health Plan (Ahp)-All Plans $30 103%
Blue Shield Mcare Adv $30 103%
Cca Health Plan Mcr Adv- All Plans $30 103%
Healthnet Mcare $30 103%
Hp Of San Joaquin Mcr Adv $30 103%
Humana $30 103%
Kaiser Mcr Adv $30 - $41 103%
Knnex Health - All Plans $30 - $37 103%
Tricare $30 103%
UnitedHealthcare $30 - $203 103%
Hp Healthy Kids Pro Fee $32 110%
Kaiser Commercial - All Other Plans $32 - $139 110%
Ah Employee Health Plan - All Plans $34 - $55 117%
Cigna $34 - $305 117%
First Health- All Plans $37 - $278 127%
Healthnet- All Other Plans $38 - $166 131%
Networks By Design- All Plans $39 - $170 134%
Beech Street- All Plans $40 - $305 138%
Hp Of San Joaquin Ppo - All Other Plans $40 - $322 138%
Multiplan- All Plans $40 - $271 138%
Western Growers- All Plans $44 - $435 151%
Blue Cross Blue Shield $47 - $499 162%
Bright Health - All Plans $61 210%
Three Rivers Provider Network- All Plans $70 - $305 241%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals