CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Paradise Valley Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $36
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Paradise Valley Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$36

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $36 (110%)
Insurance Median: $36 (110%)
Cash: $36 (110% of Medicare)
Ins. Median: $36 (110% 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
Aetna $18 - $46 55%
Blue Sheid Of Promise $18 55%
County Of San Diego $18 55%
Golden Physicians Medical Group $18 - $45 55%
Health Excel Ins $18 - $36 55%
Heritage Provider Netwrok $18 - $47 55%
Molina $18 - $36 55%
Traditional Medi-Cal $18 55%
UnitedHealthcare $18 - $36 55%
Health Net Of Ca $19 - $53 58%
Community Health Group $21 - $36 64%
Blue Shield Of Ca, Va $36 110%
Ca Foundation For Medical Care $36 110%
Central Health $36 110%
Choice Physicians Network $36 110%
Clever Care Of Golden State, Inc $36 110%
Managed Health Network $36 110%
Medicare (plans) $36 110%
Renal Payer Solutions $36 110%
Tricare $36 110%
Usa Senior Care Network $36 110%
Verda Health Plan $36 110%
Brand New Day $37 - $54 113%
Imperial Health Plan Of Ca $38 116%
Health Net Federal Service (Cdcr) $45 137%
Veterans Evaluation Services $45 137%
Integrated Medical Solutions $48 147%
Worker Comp $48 147%
Ca Dept Of Correction & Rehab $51 156%
Employer Direct Healthcare $51 156%
Naphcare $56 - $72 171%
Scripps Health $61 186%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals