CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Whittier Hospital Medical Center
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $71
- Cash Discount Price: $19
- vs. Medicare Baseline: 2.44x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Whittier Hospital Medical Center is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $19. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.44x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$19
Average discount available for prompt cash payment at this facility.
Insurance Median
$71
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: $19 (65%)
Insurance Median: $71 (244%)
Cash: $19 (65% of Medicare)
Ins. Median: $71 (244% 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 244% of the Medicare baseline (a markup of 144%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $4 - $293 | 14% |
| Aids Healthcare Foundation | $9 - $32 | 31% |
| Allied Physicians | $9 - $48 | 31% |
| Kaiser Foundation | $9 - $214 | 31% |
| Synermed | $9 - $32 | 31% |
| Physician Healthways | $10 - $30 | 34% |
| Ahmc Medi-Cal Reciprocity Agreement | $11 | 38% |
| Alta Med Health Network | $11 - $32 | 38% |
| Altamed Health Services Corporation | $11 | 38% |
| Beverly Hospital | $11 - $35 | 38% |
| Brand New Day | $11 - $39 | 38% |
| Emanate Health | $11 - $39 | 38% |
| Health Net | $11 - $182 | 38% |
| Healthy Way La | $11 | 38% |
| Heritage Provider Network | $11 - $43 | 38% |
| La Care Healthy Families/Healthy Kids | $11 | 38% |
| Non Contracted Medi-Cal | $11 | 38% |
| Physicians Healthways Medical Corporation | $11 | 38% |
| Prospect Health Plan | $11 - $51 | 38% |
| Monarch Healthplan | $12 | 41% |
| Avanti | $13 - $38 | 45% |
| Care First Health Plan | $13 | 45% |
| County Of Los Angeles Dept Of Health Services | $13 | 45% |
| Hollywood Presbyterian Adv Med Mcal | $13 | 45% |
| Hollywood Presbyterian Medpoint Mcal | $13 | 45% |
| La Care Health Plan | $13 - $168 | 45% |
| Medi Caid/ Medi Cal | $13 | 45% |
| Caloptima | $15 - $32 | 52% |
| Veterans Administration | $22 | 76% |
| Ahmc Reciprocity | $29 - $92 | 100% |
| Ahmc Reciprocity Agreement Senior/Commercial | $29 - $92 | 100% |
| Wear And Wood | $29 - $122 | 100% |
| Aetna | $30 - $222 | 103% |
| Applecare Medical Group | $30 | 103% |
| Alignment Health Plan | $32 | 110% |
| Alta Los Angeles Hospitals Inc | $32 | 110% |
| Apa/Aco Inc | $32 | 110% |
| Blue Shield Of California | $32 - $433 | 110% |
| Caremore | $32 | 110% |
| Central Health Plan | $32 | 110% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $32 | 110% |
| Easy Choice Health Plan | $32 | 110% |
| Fmc Los Angeles County | $32 - $229 | 110% |
| Humana | $32 | 110% |
| Interplan Health Group | $32 | 110% |
| La Care Covered Direct | $32 | 110% |
| Medicare (plans) | $32 - $33 | 110% |
| Pacific Alliance Medical Center | $32 | 110% |
| Pacificare Of California | $32 | 110% |
| Private Pay | $32 | 110% |
| Scan Health Plan | $32 | 110% |
| Self-Pay | $32 | 110% |
| Tricare | $32 | 110% |
| Athens Administrators Ahmc Work Comp | $33 | 114% |
| Misc 1 | $33 | 114% |
| Molina Healthcare Of California | $33 | 114% |
| Multiplan Wc | $33 | 114% |
| San Miguel Health Plan | $35 | 120% |
| Molina Medical Center | $37 - $119 | 127% |
| Central Health Plan Of California | $38 - $122 | 131% |
| Chinatown Service Center Pace | $38 | 131% |
| Ahmc Health | $40 | 138% |
| Knox-Keene Act | $40 | 138% |
| UnitedHealthcare | $46 - $267 | 158% |
| Prospect Medical | $53 - $168 | 182% |
| Care 1St Health Plan | $58 - $183 | 200% |
| New Horizon Medical Group Inc | $58 - $183 | 200% |
| Capnet | $60 | 206% |
| Pacific Independent Physician Association | $60 | 206% |
| Cost Containment | $62 - $198 | 213% |
| Universal Care | $62 - $214 | 213% |
| Edward Medical Group | $65 | 224% |
| Asi/Flex | $67 - $214 | 231% |
| Us Comp Care | $67 - $214 | 231% |
| Value Healthplan Of California | $67 - $214 | 231% |
| Allied Physicians Ipa | $69 | 237% |
| Community Care Network | $72 - $229 | 248% |
| Coventry Health Care | $72 - $229 | 248% |
| Coventry Health Care National Network | $72 - $229 | 248% |
| Interplan Corporation | $72 - $229 | 248% |
| Managed Care Administrators | $72 - $229 | 248% |
| Prohealth | $72 - $229 | 248% |
| Health Net Inc | $79 - $135 | 272% |
| Multiplan | $82 - $259 | 282% |
| Davita Healthcare Partners | $94 | 323% |
| Cigna | $96 - $305 | 330% |
| Commercial Non Contract | $96 - $305 | 330% |
| Healthnet | $96 - $234 | 330% |
| Medi-Cal Sub Acute | $96 - $305 | 330% |
| One Legacy | $96 - $305 | 330% |
| Great-West Healthcare Of California | $2,500 | 8603% |