CMS Price Transparency Data
Physical therapy (therapeutic exercise)
Facility: Clovis Community Medical Center
Billing Code: 97110 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97110
- Insurance Median: $30
- Cash Discount Price: $158
- vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Clovis Community Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $158. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.03x the Medicare baseline. Located in 2755 Herndon Ave, Clovis, CA.
Cash / Self-Pay
$158
Average discount available for prompt cash payment at this facility.
Insurance Median
$30
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: $158 (544%)
Insurance Median: $30 (103%)
Cash: $158 (544% of Medicare)
Ins. Median: $30 (103% 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.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Cal Caloptima | $6 | 21% |
| Ccs Fresno | $6 | 21% |
| Ccs Mariposa | $6 | 21% |
| Medi-Cal Blue Shield Promise Health | $6 | 21% |
| Medi-Cal La Care Health | $6 | 21% |
| Generic Care Out of County | $6 | 21% |
| Medi-Cal Inland Empire Health | $6 | 21% |
| Ccs Kern | $6 | 21% |
| Medi-Cal Partnership Health Plan of Ca | $6 | 21% |
| Blue Cross Blue Shield | $6 - $125 | 21% |
| Medi-Cal Contra Costa Health Plan | $6 | 21% |
| Medi-Cal Molina | $6 | 21% |
| Medi-Cal Community Health Group | $6 | 21% |
| Generic Ccs Other Counties | $6 | 21% |
| Ccs Tulare | $6 | 21% |
| Fresno County Funded Specialty Care | $6 | 21% |
| Medi-Cal Alameda Alliance for Health | $6 | 21% |
| Medi-Cal Health Plan of San Mateo | $6 | 21% |
| Blue Shield | $6 - $408 | 21% |
| Ccs Madera/Sacramento | $6 | 21% |
| Genetically Handicapped Person | $6 | 21% |
| Ccs Merced | $6 | 21% |
| Chdp | $6 | 21% |
| Santa Clara Family Health Plan - Premier Health | $6 | 21% |
| Santa Clara Family Health Plan - Valley Health | $6 | 21% |
| Gold Coast Medi-Cal | $6 | 21% |
| Ccs Kings | $6 | 21% |
| Medi-Cal Cencal Health | $6 | 21% |
| San Francisco Health Plan Medi-Cal | $6 | 21% |
| Medi-Cal California Health & Wellness Plan | $6 | 21% |
| Ccs Stanislaus | $6 | 21% |
| Medi-Cal Kern Family Health | $6 | 21% |
| Sante | $10 - $30 | 34% |
| Health Plan of San Joaquin | $10 | 34% |
| Sequoia Pace | $10 | 34% |
| Adventist -McL Calviva Sub Cap | $11 | 38% |
| Healthnet | $12 - $372 | 41% |
| Blue Shield Sante | $30 | 103% |
| Care1St HMO - Ehs | $30 | 103% |
| Advantek Table Mountain Rancheria Tribal Member | $30 | 103% |
| Aetna | $30 - $98 | 103% |
| Meritage Blue Shield 65 Plus | $30 | 103% |
| Bscphp HMO - First Choice | $30 | 103% |
| Bscphp - Dhmso | $30 | 103% |
| Gemcare HMO | $30 | 103% |
| Brand New Day | $30 | 103% |
| Meritage Brand New Day | $30 | 103% |
| Scan Health Plan | $30 | 103% |
| Kaiser | $30 | 103% |
| Generic | $30 | 103% |
| Healthnet Sante - Sub Cap Dual Risk | $30 | 103% |
| Cigna | $30 - $419 | 103% |
| Generic Bscphp | $30 | 103% |
| Humana | $30 - $167 | 103% |
| Sante-Healthnet Seniority | $30 | 103% |
| Cares Act Provider Relief Fund | $30 | 103% |
| Healthnet HMO - La Salle | $30 | 103% |
| Sante-Sub Cap Ma Brand New Day | $30 | 103% |
| Blue Shield Hmo-Cvmp/Medpro | $30 | 103% |
| Healthnet HMO - Sante | $30 | 103% |
| Todays Pyramid | $30 | 103% |
| UnitedHealthcare | $30 - $377 | 103% |
| Meritage Healthnet HMO | $30 | 103% |
| Wellcare | $30 | 103% |
| Healthnet HMO - Dhmso | $30 | 103% |
| Sante Sub Cap-Blue Shield/Sante | $30 | 103% |
| Hartford Life Supplement | $30 | 103% |
| Well Path (Cfmg) | $30 - $217 | 103% |
| Blue Shield Saint Agnes | $30 | 103% |
| Medicare (plans) | $30 | 103% |
| Healthnet Sante | $30 | 103% |
| Blue Shield Promise - Imperial | $30 | 103% |
| Victims of Crime | $30 | 103% |
| Railroad Part B | $30 | 103% |
| Medi-Cal Innovative Integrated Health | $30 | 103% |
| Sequoia Pace - Peak Tpa | $30 | 103% |
| Generic Victims of Crime | $30 | 103% |
| Us Marshal | $30 | 103% |
| Sante-Blue Shield/Sante | $30 | 103% |
| Railroad Part A & B | $30 | 103% |
| Healthnet Sante Dual Risk | $30 | 103% |
| Healthnet HMO - Cvmp/Medpro | $30 | 103% |
| Bscphp - First Choice | $30 | 103% |
| Blue Shield 65 Plus HMO Ehs | $30 | 103% |
| Sante Sub Cap Healthnet Seniority | $30 | 103% |
| Blue Shield 65 Plus HMO First Choice | $30 | 103% |
| Railroad Part A | $30 | 103% |
| Innovative Integrated Health Community Plans HMO | $34 | 117% |
| Alignment Health Plan | $34 | 117% |
| Champion Health Plan of California Ma | $34 | 117% |
| Imperial Health Plan HMO | $35 | 120% |
| Correctcare Integrated Health | $40 | 138% |
| Central Valley Medical Providers | $49 - $138 | 169% |
| Community Care | $50 | 172% |
| Coalinga State Hospital | $61 | 210% |
| Naphcare Inc-Mendota | $66 | 227% |
| Employer 90/40 | $79 | 272% |
| Nx Health Network PPO | $108 | 372% |
| Central Ca Indian Health | $108 | 372% |
| Healthsmart | $134 - $158 | 461% |
| Coventry Health Care (First Health Network) | $148 | 509% |
| Network By Design | $148 | 509% |
| PHCS | $167 | 575% |
| Generic Multiplan | $167 | 575% |
| Physmetrics Health | $285 | 981% |