CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Watsonville Community Hospital
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $208
- Cash Discount Price: $188
- vs. Medicare Baseline: 7.16x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Watsonville Community Hospital is $208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 7.16x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.
Cash / Self-Pay
$188
Average discount available for prompt cash payment at this facility.
Insurance Median
$208
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: $188 (647%)
Insurance Median: $208 (716%)
Cash: $188 (647% of Medicare)
Ins. Median: $208 (716% 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 716% of the Medicare baseline (a markup of 616%). 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Healthy Families | $14 - $19 | 48% |
| Medi-Cal E.R. | $14 - $19 | 48% |
| California Childrens Srvs | $14 - $19 | 48% |
| Well Path | $14 - $373 | 48% |
| Medicaid / KanCare | $14 - $19 | 48% |
| Ccs/Monterey County | $14 - $19 | 48% |
| Medi-Cal/Eds | $14 - $19 | 48% |
| Alliance/Sccho | $19 - $27 | 65% |
| Fleming & Associates | $32 | 110% |
| Medicare (plans) | $32 | 110% |
| Beta Healthcare Group | $32 | 110% |
| Hartford Workers' Comp | $32 | 110% |
| Keenan & Assoc Work Comp | $32 | 110% |
| Secure Horizons | $32 | 110% |
| Health Net of California | $32 - $234 | 110% |
| Veterans Administration | $32 | 110% |
| Liberty Mutual Work Comp | $32 | 110% |
| UnitedHealthcare | $32 - $224 | 110% |
| Crawford & Co | $32 | 110% |
| Fireman's Fund Work Comp | $32 | 110% |
| Travelers Insurance | $32 - $373 | 110% |
| U.S. Dept. of Labor | $32 | 110% |
| Secure Horizons Dign HMO | $32 - $75 | 110% |
| Republic Idemnity W/Comp | $32 | 110% |
| Pinnacle Healthcare Uc | $32 | 110% |
| Gallagher Bassett Svcs | $32 | 110% |
| Workers Comp | $32 | 110% |
| Tricare | $32 | 110% |
| Ace-Usa | $32 | 110% |
| Blue Shield PPO | $32 | 110% |
| Miscellaneous Work Comp | $32 | 110% |
| Alignment Health Plan | $32 | 110% |
| Kemper Group Workers Comp | $32 | 110% |
| Western Growers Work Comp | $32 | 110% |
| Victim Compensation Plan | $46 - $373 | 158% |
| Medicruz | $46 - $67 | 158% |
| Health Net Pmg HMO | $51 - $234 | 175% |
| Aetna | $51 - $305 | 175% |
| Cigna | $51 - $261 | 175% |
| Great-West/Phcs | $51 - $261 | 175% |
| Blue Cross Blue Shield | $51 - $332 | 175% |
| Pacificare HMO | $51 - $224 | 175% |
| Blue Shield HMO | $51 - $75 | 175% |
| Pinnacle Claims Tpa/Bc | $102 - $332 | 351% |
| Western Growers Trust/Bc | $102 - $332 | 351% |
| Kaiser Northern | $104 | 358% |
| Western Health Advantage | $127 - $186 | 437% |
| Pacificare PPO | $152 - $224 | 523% |
| Health Net Smartcare Netw | $152 - $224 | 523% |
| Self Pay | $152 - $224 | 523% |
| Health Net Canopycare HMO | $159 - $234 | 547% |
| Health Net Blue and Gold | $159 - $234 | 547% |
| Geha (Ccn) | $178 - $298 | 613% |
| Adventist Risk Management | $178 - $298 | 613% |
| First Health | $178 - $298 | 613% |
| Transwestern | $178 - $298 | 613% |
| Multiplan Inc PPO | $198 - $291 | 681% |
| Private Healthcare System | $198 - $291 | 681% |
| Coastal Healthcare Admin | $216 - $335 | 743% |
| Salinas Valley Mem Hops | $216 - $317 | 743% |
| Laborers Health & Welfare | $220 - $332 | 757% |
| Calif Ironworkers Field | $220 - $332 | 757% |
| Delta Health Systems | $220 - $332 | 757% |
| Monterey Bay Pub Emp Trst | $220 - $332 | 757% |
| Claims Management Wc | $220 - $332 | 757% |
| Operating Engineers | $220 - $332 | 757% |
| Teamsters Benefit Trust | $220 - $332 | 757% |
| State Compensation Fund | $220 - $332 | 757% |
| Robert Kennedy/Ccn | $220 - $332 | 757% |
| Sheet Metal Workers | $220 - $332 | 757% |
| City of Wats/Pinnacle Clm | $220 - $332 | 757% |
| Carpenters H&W Trust | $220 - $332 | 757% |
| Prucare Pmg POS | $254 - $373 | 874% |
| State Farm Ins | $254 - $373 | 874% |
| Bankers Life & Casualty | $254 - $373 | 874% |
| North Calif Bakery Driver | $254 - $373 | 874% |
| Aaa | $254 - $373 | 874% |
| Allstate | $254 - $373 | 874% |
| Physicians Mutual | $254 - $373 | 874% |
| Wholesale Beer Distributo | $254 - $373 | 874% |
| Aarp | $254 - $373 | 874% |
| United Administrative | $254 - $373 | 874% |
| Humana | $254 - $373 | 874% |
| Sutter Health Plus | $254 - $373 | 874% |
| Apwu Health Plan | $254 - $373 | 874% |
| Miscellaneous Insurance | $254 - $373 | 874% |
| Prucare Pmg HMO | $254 - $373 | 874% |
| Zenith National Ins | $254 - $373 | 874% |
| Miscellaneous Auto | $254 - $373 | 874% |
| Farmers Insurance | $254 - $373 | 874% |