CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Greater El Monte Community Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $99
  • Cash Discount Price: $198
  • vs. Medicare Baseline: 3.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Greater El Monte Community Hospital is $99. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.41x the Medicare baseline. Located in 1701 Santa Anita Ave, South El Monte, CA.
Cash / Self-Pay
$198

Average discount available for prompt cash payment at this facility.

Insurance Median
$99

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: $198 (681%)
Insurance Median: $99 (341%)
Cash: $198 (681% of Medicare)
Ins. Median: $99 (341% 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 341% of the Medicare baseline (a markup of 241%). 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
Emanate Health $9 - $40 31%
Aids Health Foundation $11 - $32 38%
Altamed Health Network $11 - $32 38%
Avanti $11 - $38 38%
Beverly Hospital $11 - $35 38%
Brand New Day $11 - $40 38%
Health Net Foundation $11 - $172 38%
Healthy Way La $11 38%
La Care Health Plan $11 - $158 38%
Other Non Contracted Medi-Cal Hmo $11 38%
State Of California $11 38%
Allied Physicians $13 - $47 45%
Associated Hispanic Physicians $13 - $32 45%
Caloptima $13 45%
Hollywood Presbyterian Adv Med Mcal $13 45%
Hollywood Presbyterian Medpoint Mcal $13 45%
Care 1St Medi Cal Hmo Cap Exceptional Care $14 - $29 48%
Blue Cross Blue Shield $16 - $223 55%
Clinica Medica Familiar $16 - $144 55%
In Custody-Ca Highway Patrol $20 69%
Veterans Administration $22 76%
Central Health Plan $23 - $201 79%
Bella Vista Medical Group Ipa $27 - $129 93%
Employee Health Systems Medical Group $27 - $57 93%
Global Care Medical Group Ipa $27 - $129 93%
Intercomp $30 103%
Alignment Health Plan $32 110%
Apa/Aco Inc $32 110%
Blue Shield Of California $32 - $433 110%
Champus Foundation $32 110%
Cms $32 110%
Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P $32 110%
Easy Choice Health Plan $32 110%
Good Samaritan Medical Practice Assoc $32 - $172 110%
Health Net Inc $32 - $234 110%
Interplan $32 - $215 110%
La Care Covered Direct $32 110%
Other Non Contracted Senior Hmo $32 110%
Pacific Alliance Medical Center Reciprocal Contract $32 110%
Pacificare Of California $32 - $249 110%
Preferred Health Network $32 110%
Scan Health Plan $32 110%
Self-Pay $32 110%
UnitedHealthcare $32 - $246 110%
Athens Administrators $33 114%
Molina Healthcare $33 114%
Multiplan $33 - $244 114%
Other Non Contracted Work Comp $33 114%
Alta Med Health Services Med Grp $34 - $72 117%
Inter Valley Health Plan $34 117%
Molina Healthcare Of California $34 - $112 117%
San Miguel Health Plan $35 120%
Chinatown Service Center Pace $38 131%
Ahmc Health Self-Insurance Epo $40 138%
Knox-Keene Act $40 138%
Ahmc Reciprocity Agreement $41 - $86 141%
Ahmc Reciprocity Agreement Senior/Commercial $41 - $86 141%
Lincoln Hospital Medical Center $41 - $86 141%
Allied Physicians Medical Group $60 206%
California Thoroughbred Horesmans Foundation $68 - $144 234%
Universal Care $68 - $201 234%
Care 1St Health Plan $82 - $172 282%
Cost Containment Strategies $88 - $187 303%
In Custody Police Dept $88 - $187 303%
Community Care Network $109 - $230 375%
Health Payors Organization $122 - $258 420%
Cigna $136 - $287 468%
Commercial Non Contract $136 - $287 468%
Medi-Cal Sub Acute $136 - $287 468%
Nuclear Medicine/Whmc $136 - $287 468%
One Legacy $136 - $287 468%

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