CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Valley Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $85
  • Cash Discount Price: $125
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Valley Medical Center is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $125. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.92x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$125

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $125 (430%)
Insurance Median: $85 (292%)
Cash: $125 (430% of Medicare)
Ins. Median: $85 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Humana $32 110%
UnitedHealthcare $32 - $85 110%
Regence Blue Shield [170100] $41 - $44 141%
Regence Uniform [130111] $42 145%
Blue Cross Blue Shield $44 - $47 151%
Regence Hma [170105] $44 151%
Regence Hma1 [170102] $44 151%
Bh United [180100] $46 158%
Aetna $77 265%
Benefit Md [150113] $85 292%
Carpenters Trust [150122] $85 292%
Cement Masons And Plasterers [150127] $85 292%
Coresource [150109] $85 292%
Employee Benefit Management Services [150108] $85 292%
Fc Moda Health [150139] $85 292%
First Choice Health Administrators [150110] $85 292%
First Choice Health Comp [150112] $85 292%
First Choice [150134] $85 292%
Health Net [150111] $85 292%
Here [150114] $85 292%
Hotel Employees Health Trust [150115] $85 292%
International Longshore & Warehouse Union [150116] $85 292%
Kitsap Physician Services [150118] $85 292%
Loomis Benefits West [150119] $85 292%
Mega [150120] $85 292%
Midwest [150121] $85 292%
Nw Administrators [150123] $85 292%
Operating Engineers [150125] $85 292%
Painters Trust [150126] $85 292%
Puget Sound Electric [150131] $85 292%
Seattle Plumb And Pipe [150132] $85 292%
Trusteed Plan [150101] $85 292%
United Employee Benefit Trust [150137] $85 292%
Washington Bakers Trust [150102] $85 292%
Washington Employers Trust [150103] $85 292%
Washington State Health Ins Pool [150104] $85 292%
Welfare Pension Administration Services [150105] $85 292%
Zenith Admin [150106] $85 292%
Zzjohn Alden [150117] $85 292%
Zzprincipal Financial Group [150128] $85 292%
Zzprovidence [150129] $85 292%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals