CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: West Valley Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $103
Cash Discount Price: $298
vs. Medicare Baseline: 3.54x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at West Valley Medical Center is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $298. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.54x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$298

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $298 (1025%)

Insurance Median: $103 (354%)

Cash: $298 (1025% of Medicare)

Ins. Median: $103 (354% 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 354% of the Medicare baseline (a markup of 254%). 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
Blue Cross Blue Shield	$24 - $2,918	83%
Humana	$24 - $250	83%
Molina	$24 - $28	83%
Regence Blue Shield	$24 - $28	83%
St Luke'S Health Partners	$24 - $194	83%
Veteran'S Administration	$24 - $28	83%
United	$25 - $178	86%
Regence	$67	231%
Select Health Idaho (Eirmc Only)	$95	327%
Corizon Health	$110	379%
True Blue	$118	406%
Cigna	$167	575%
Pacificsource Health	$178	613%
Moda	$186	640%
Aetna	$236	812%
Four Rivers Hospice	$238	819%
Multiplan	$238	819%
Geha Ppo Usa	$253	871%
Coventry First Health	$268	922%
St Alphonsus Health	$268	922%

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 $298.
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 West Valley Medical Center 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.