CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Loma Linda University Children's Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $221
Cash Discount Price: $149
vs. Medicare Baseline: 7.60x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Loma Linda University Children's Hospital is $221. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $149. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 7.60x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$149

Average discount available for prompt cash payment at this facility.

Insurance Median

$221

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: $149 (513%)

Insurance Median: $221 (760%)

Cash: $149 (513% of Medicare)

Ins. Median: $221 (760% 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 760% of the Medicare baseline (a markup of 660%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Inland Empire Health Plan (Iehp)	$18	62%
Kaiser Foundation Hospitals	$21 - $221	72%
Adventist Health	$66 - $136	227%
Lluh Dept Of Risk Management	$79	272%
Epic Health Plan	$132	454%
Alpha Care Medical Group	$182 - $281	626%
Global Benefits Group	$199	685%
Temecula Valley Physicians Medical Group	$199	685%
Trivalley Medical Group	$199	685%
UnitedHealthcare	$206 - $417	709%
Cigna	$212 - $245	730%
Networks By Design	$215	740%
Aetna	$217	747%
Molina Healthcare Of Ca	$232	798%
Multiplan	$265	912%
Blue Shield Of California	$279 - $421	960%
Dignity Health	$281	967%
Galaxy Health	$281	967%
Prime Health Services	$281	967%
Vantage Medical Group	$281	967%
Blue Cross Blue Shield	$457	1573%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $149.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Loma Linda University Children's Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.