CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Seneca District Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $87
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Seneca District Hospital is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.99x the Medicare baseline. Located in 130 Brentwood Drive, Chester, CA.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $74 (255%)
Insurance Median: $87 (299%)
Cash: $74 (255% of Medicare)
Ins. Median: $87 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Amthem Bc Mcal $16 55%
Medi-Cal $16 55%
Ambetter / Centene $19 65%
UnitedHealthcare $35 - $90 120%
Partnership Hp-All Plans $55 189%
Tricare $64 220%
Imperial Hp Ma-All Plans $73 251%
Blue Cross Blue Shield $75 - $83 258%
Blue Shield Ipf/Ca Exchange $82 282%
Beech Street Corp- All Plans $87 299%
Cigna $87 299%
Integrated Hp-All Plans $87 299%
Interplan Corp- All Plans $87 299%
Medincrease- All Plans $87 299%
Multiplan- All Plans $87 299%
Pacificare - All Plans $87 299%
Provider Ntwrk Of America-All Plans $87 299%
Alliance- All Plans $89 306%
Community Care Network - All Plans $89 306%
Coventry- All Plans $90 310%
Northern Nevada Health Network- All Plans $90 310%
Superior California Ppo - All Plans $90 310%
Blue Shield Of Ca- All Other Plans $91 313%
Healthnet - All Other Plans $91 313%
Three Rivers- All Plans $91 313%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Brentwood Drive, Chester, CA 96020
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals