CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Martin Luther King, Jr. Community Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $38
Cash Discount Price: $126
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Martin Luther King, Jr. Community Hospital is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $126. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.31x the Medicare baseline. Located in 1680 East 120Th Street, Los Angeles, CA.

Cash / Self-Pay

$126

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $126 (434%)

Insurance Median: $38 (131%)

Cash: $126 (434% of Medicare)

Ins. Median: $38 (131% 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.

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
Alta	$11 - $32	38%
Brand New Day	$11 - $437	38%
Care1St Health	$11 - $32	38%
Molina Healthcare	$12 - $40	41%
Preferred Professional Medical Corporation (Ipa) Of California	$19 - $26	65%
La Care Health	$20	69%
Health Net	$28 - $219	96%
Heritage Provider Network (Hpn)	$30	103%
La Care Health Pasc-Seui	$38	131%
La Care Health Plan	$38	131%
Santa Monica Unite Here	$44	151%
Blue Shield Of California	$246 - $331	847%
UnitedHealthcare	$258 - $312	888%
Multiplan	$481 - $583	1655%

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 $126.
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 Martin Luther King, Jr. Community 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.