CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Greater El Monte Community Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $81
  • Cash Discount Price: $150
  • vs. Medicare Baseline: 2.40x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Greater El Monte Community Hospital is $81. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.40x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$150

Average discount available for prompt cash payment at this facility.

Insurance Median
$81

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $150 (445%)
Insurance Median: $81 (240%)
Cash: $150 (445% of Medicare)
Ins. Median: $81 (240% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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 240% of the Medicare baseline (a markup of 140%). 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
Care 1St Medi Cal Hmo Cap Exceptional Care $9 - $26 27%
Clinica Medica Familiar $11 - $130 33%
Aids Health Foundation $12 - $37 36%
Altamed Health Network $12 - $37 36%
Avanti $12 - $45 36%
Beverly Hospital $12 - $41 36%
Brand New Day $12 - $47 36%
Emanate Health $12 - $47 36%
Health Net Foundation $12 - $155 36%
Healthy Way La $12 36%
La Care Health Plan $12 - $143 36%
Other Non Contracted Medi-Cal Hmo $12 36%
State Of California $12 36%
Allied Physicians $16 - $56 47%
Associated Hispanic Physicians $16 - $38 47%
Hollywood Presbyterian Adv Med Mcal $16 47%
Hollywood Presbyterian Medpoint Mcal $16 47%
Blue Cross Blue Shield $17 - $223 50%
Caloptima $17 50%
Bella Vista Medical Group Ipa $18 - $117 53%
Employee Health Systems Medical Group $18 - $52 53%
Global Care Medical Group Ipa $18 - $117 53%
In Custody-Ca Highway Patrol $20 59%
Alta Med Health Services Med Grp $23 - $65 68%
Veterans Administration $26 77%
Ahmc Reciprocity Agreement $28 - $78 83%
Ahmc Reciprocity Agreement Senior/Commercial $28 - $78 83%
Good Samaritan Medical Practice Assoc $28 - $156 83%
Lincoln Hospital Medical Center $28 - $78 83%
Central Health Plan $30 - $182 89%
Molina Healthcare Of California $36 - $101 107%
Alignment Health Plan $37 110%
Apa/Aco Inc $37 110%
Blue Shield Of California $37 - $433 110%
Champus Foundation $37 110%
Cms $37 110%
Easy Choice Health Plan $37 110%
Health Net Inc $37 - $234 110%
Other Non Contracted Senior Hmo $37 110%
Pacific Alliance Medical Center Reciprocal Contract $37 110%
Scan Health Plan $37 110%
UnitedHealthcare $37 - $223 110%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $38 113%
La Care Covered Direct $38 113%
Pacificare Of California $38 - $225 113%
Self-Pay $38 113%
Inter Valley Health Plan $39 116%
Molina Healthcare $39 116%
Intercomp $41 122%
San Miguel Health Plan $41 122%
Preferred Health Network $43 127%
Chinatown Service Center Pace $44 130%
Interplan $44 - $195 130%
Athens Administrators $46 136%
California Thoroughbred Horesmans Foundation $46 - $130 136%
Multiplan $46 - $221 136%
Other Non Contracted Work Comp $46 136%
Universal Care $46 - $182 136%
Ahmc Health Self-Insurance Epo $47 139%
Knox-Keene Act $47 139%
Care 1St Health Plan $55 - $156 163%
Allied Physicians Medical Group $60 178%
Cost Containment Strategies $60 - $169 178%
In Custody Police Dept $60 - $169 178%
Community Care Network $74 - $208 219%
Health Payors Organization $83 - $234 246%
Cigna $92 - $260 273%
Commercial Non Contract $92 - $260 273%
Medi-Cal Sub Acute $92 - $260 273%
Nuclear Medicine/Whmc $92 - $260 273%
One Legacy $92 - $260 273%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1701 Santa Anita Ave, South El Monte, CA 91733
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals