CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Adventist Health Mendocino Coast

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $78
Cash Discount Price: $92
vs. Medicare Baseline: 2.68x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Adventist Health Mendocino Coast is $78. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $92. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.68x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$92

Average discount available for prompt cash payment at this facility.

Insurance Median

$78

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: $92 (317%)

Insurance Median: $78 (268%)

Cash: $92 (317% of Medicare)

Ins. Median: $78 (268% 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 268% of the Medicare baseline (a markup of 168%). 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
Medi-Cal	$11 - $16	38%
Partnership Hp Mcal-All Plans	$16 - $47	55%
Cigna	$30 - $156	103%
Tricare	$30 - $98	103%
UnitedHealthcare	$30 - $162	103%
Blue Cross Blue Shield	$31 - $470	107%
Ah Employee Health Plan - All Plans	$34 - $104	117%
Blue Shield Epn	$42 - $76	145%
Blue Shield - All Other Plans	$44 - $154	151%
Healthnet - All Plans	$44 - $130	151%
Ahcc - All Plans	$78 - $180	268%
Beech Street - All Plans	$78 - $180	268%
Great West Hmo/Pos/Epo/Oa	$78 - $130	268%
Great West Ppo - All Other Plans	$78 - $140	268%
Multiplan - All Plans	$78 - $140	268%

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 $92.
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 Adventist Health Mendocino Coast 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.