CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: San Gorgonio Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $35
  • Cash Discount Price: $46
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at San Gorgonio Memorial Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $46. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.
Cash / Self-Pay
$46

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $46 (141%)
Insurance Median: $35 (107%)
Cash: $46 (141% of Medicare)
Ins. Median: $35 (107% 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
Lasalle Medical Associates $33 101%
Beaver Medical Group $34 104%
Blue Cross Blue Shield $34 - $111 104%
Blue Shield $34 104%
Choice Physicians Network $34 104%
Heritage Provider Network $34 104%
Inland Empire Health Plan $34 - $38 104%
Kaiser $34 - $103 104%
Providence Health Network $34 104%
Redlands Community Hospital $34 104%
UnitedHealthcare $34 104%
Easy Choice Health Plan $36 110%
Epic Management $36 110%
Health Net $38 - $49 116%
Velocity $38 116%
Imperial Health Plan $39 119%
Cigna $165 504%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 North Highland Springs Avenue, Banning, CA 92220
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals