CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Riverside Community Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $34
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Riverside Community Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $345 (1054%)
Insurance Median: $34 (104%)
Cash: $345 (1054% of Medicare)
Ins. Median: $34 (104% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $32.73 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

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
La Care Health $14 43%
Molina $14 43%
Brand New Day $15 - $34 46%
Inland Empire Health Plan $20 - $59 61%
Bristol Hospice $24 - $28 73%
Aetna $30 - $67 92%
Alignment Health Plan $30 - $34 92%
Blue Cross Blue Shield $30 - $34 92%
Central Health Plan $30 - $34 92%
Clever Care Of Golden State $30 - $34 92%
Easy Choice Health Plan $30 - $34 92%
Heritage Provider Network $30 - $47 92%
Humana $30 - $34 92%
Redlands Community Hospital $30 - $34 92%
Riverside Medical Clinic $30 - $41 92%
Riverside Physician $30 - $34 92%
Scan Health Plan $30 - $34 92%
Triwest Healthcare Alliance $30 - $34 92%
UnitedHealthcare $30 - $34 92%
Care1St Health Plan $31 - $35 95%
United $31 - $98 95%
Blue Shield $32 - $82 98%
Health Net $34 - $83 104%
Corvel Corporation $35 - $40 107%
Healthsmart $36 - $298 110%
Next $36 - $298 110%
Medcare Partners $48 - $56 147%
Bright Health $126 - $148 385%
First Health $140 - $335 428%
American Health System $143 - $168 437%
Multiplan $255 - $317 779%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4445 Magnolia Avenue, Riverside, CA 92501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals