CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: John Muir Medical Center - Concord Campus

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $144
  • Cash Discount Price: $129
  • vs. Medicare Baseline: 4.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at John Muir Medical Center - Concord Campus is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $129. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.96x the Medicare baseline. Located in 2540 East St, Concord, CA.
Cash / Self-Pay
$129

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

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: $129 (444%)
Insurance Median: $144 (496%)
Cash: $129 (444% of Medicare)
Ins. Median: $144 (496% 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 496% of the Medicare baseline (a markup of 396%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Contra Costa County Jail [1012104] $11 38%
Jmpn Canopy Hn [1640000011] $33 114%
UnitedHealthcare $33 - $167 114%
Health Net-Network Mcare [1028127] $35 120%
Alignment Health [1177113] $36 124%
Blue Cross Blue Shield $36 - $504 124%
Care 1St Health Plan [1094113] $36 124%
Caremore [1171113] $36 124%
Easy Choice Health Plan [1083113] $36 124%
Essence Healthcare [1049028] $36 124%
Essence Healthcare [1049128] $36 124%
Generic Commercial/Indemnity [1017001] $36 - $114 124%
Generic Hmo [1018103] $36 124%
Generic Ppo [1021104] $36 124%
Golden State-Network Mcare [1023127] $36 124%
Humana $36 - $238 124%
Medicare (plans) $36 - $229 124%
Veterans Administration [1051113] $36 124%
Aetna $37 - $212 127%
Covid19 Hrsa Uninsured Testing And Treatment Fund [1179012] $37 127%
Hospice Of East Bay [1085104] $37 127%
Scan-Network Mcare [1043127] $37 127%
Tricare $37 127%
Workers' Comp [1024005] $44 151%
Canopy Hn Hmo [1166103] $65 224%
Carecentrix [1011001] $114 392%
Aps Healthcare [1003103] $129 444%
United Behavioral Health [1048103] $144 496%
Cigna $145 - $205 499%
Carelon Behavioral Health [1050104] $157 540%
Fortified Provider Network [1063104] $157 540%
Medigap [1036001] $157 540%
Three Rivers Provider Network [1073104] $157 540%
Health Net Hmo [1028103] $163 561%
Health Net-Network [1028026] $163 561%
Contra Costa Health Plan Hmo [1013103] $172 592%
Blue Shield Hmo [1006103] $177 - $182 609%
Blue Shield-Network [1006026] $182 626%
Blue Shield Ppo [1006104] $190 - $211 654%
Western Health Advantage Hmo [1053103] $200 - $229 688%
Health Net Ppo [1028104] $208 716%
Kaiser Hmo [1033103] $212 730%
Federal Correction Institute [1062104] $229 788%
First Health [1016104] $229 - $243 788%
Healthsmart - Pka Interplan [1031104] $229 788%
Networks By Design [1084104] $229 788%
Pponext [1072104] $229 788%
Sutter Preferred Health Plan [1044104] $229 788%
Health Management Network [1066104] $243 836%
Healthcomp [1089104] $243 - $418 836%
Galaxy Health Network [1064104] $258 888%
Integrated Health Plan [1075104] $258 888%
Brms [1091104] $418 1438%
Delta Health Systems [1032104] $418 1438%
Empire Plan [1092104] $418 1438%
Donor Network West [1008103] $8,000 - $12,000 27529%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2540 East St, Concord, CA 94520
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals