CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Valley Children's Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $130
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.47x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Valley Children's Hospital is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 4.47x the Medicare baseline. Located in 9300 Valley Childrens Place, Madera, CA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$130

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%)
Insurance Median: $130 (447%)
Ins. Median: $130 (447% 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 447% of the Medicare baseline (a markup of 347%). 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
Allcare Ipa $13 - $118 45%
Community Care Ipa $13 - $20 45%
Kaiser $13 - $153 45%
Dignity Ipa_Formerly Img $18 62%
La Salle Ipa $18 62%
Sante Ipa $18 62%
Central Valley Medical Providers Ipa $19 - $118 65%
Sequoia Health Ipa $19 65%
United Physicians Network Ipa $19 - $118 65%
Univseral Healthcare Ipa $19 65%
Adventist $22 76%
Blue Cross Blue Shield $23 - $719 79%
Cencal Health $25 86%
Kern Family Health Care $25 86%
Health Net $83 - $155 286%
Dignity Health Central Coast $117 403%
Community Health $130 447%
Stanislaus Partners In Health $130 447%
Physicians Choice Medical Group $132 454%
Health Plan Of San Joaquin $142 489%
Fowler Packing $146 502%
Dignity (Formerly Managed Care Systems) $149 513%
Kern Legacy $153 526%
Aetna $158 544%
Blue Shield $158 - $179 544%
UnitedHealthcare $158 - $168 544%
First Health Formerly Coventry $175 602%
Bakersfield Family Medical Group $177 609%
Network By Design $183 630%
Community Care Health Plan $189 650%
Health Smart $189 650%
Key Medical Ipa $189 650%
Sutter Health $201 692%
Multiplan $226 778%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9300 Valley Childrens Place, Madera, CA 93636
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens