CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Adventist Health White Memorial
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $44
- Cash Discount Price: $68
- vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health White Memorial is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.34x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$68
Average discount available for prompt cash payment at this facility.
Insurance Median
$44
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: $68 (208%)
Insurance Median: $44 (134%)
Cash: $68 (208% of Medicare)
Ins. Median: $44 (134% 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
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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 |
|---|---|---|
| Access Medi-Cal | $18 | 55% |
| Ahp Medi-Cal | $18 | 55% |
| Alta Los Angeles Mcal 1/1/19 | $18 | 55% |
| Avanti Mcal | $18 | 55% |
| Healthcare Inc Medi-Cal | $18 | 55% |
| Lasalle Mg Medi-Cal | $18 | 55% |
| Medi-Cal | $18 | 55% |
| Molina Medi-Cal | $18 | 55% |
| Pacific Alliance Medi-Cal | $18 | 55% |
| Pacific Ipa Medi-Cal | $18 | 55% |
| Preferred Ipa La Care Mcal Cap | $18 | 55% |
| Preferred Medi-Cal | $18 | 55% |
| Altamed Medi-Cal - All Other Plans | $20 | 61% |
| Fcs Ipa Medi-Cal Op/Profee Only | $21 | 64% |
| Healthnet Mcal | $21 | 64% |
| Preferred Healthy | $22 | 67% |
| Bc Medi-Cal | $23 | 70% |
| Assoc Hispanic Physcns Mcal | $25 | 76% |
| Access Group | $31 | 95% |
| Ahp - All Other Plans | $31 | 95% |
| Lasalle Mg Commercial - All Other Plans | $31 | 95% |
| Access Senior - All Other Plans | $36 | 110% |
| Ahp Senior | $36 | 110% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $36 | 110% |
| Altamed Connect | $36 | 110% |
| Avanti Mcr Adv - All Other Plans | $36 | 110% |
| Brand New Day Mcare - All Plans | $36 | 110% |
| Bs Va Mcare | $36 | 110% |
| Care First Mcare - All Other Plans | $36 | 110% |
| Clever Care - All Plans | $36 | 110% |
| Fcs Ipa Mcr Advan Op/Profee Only | $36 | 110% |
| Humana | $36 | 110% |
| Lasalle Mg Senior | $36 | 110% |
| Medicare (plans) | $36 | 110% |
| Molina Mcare | $36 | 110% |
| Pacific Alliance Mcare - All Other Plans | $36 | 110% |
| Preferred Senior | $36 | 110% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $36 | 110% |
| Tricare | $36 | 110% |
| UnitedHealthcare | $36 - $188 | 110% |
| Blue Cross Blue Shield | $38 - $549 | 116% |
| Fcs Ipa Op/Profee Only - All Other Plans | $38 | 116% |
| Bright Health - All Plans | $42 | 128% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $43 | 131% |
| Preferred Commercial - All Other Plans | $43 | 131% |
| Blue Shield Medi-Cal | $44 | 134% |
| Intergrated Medical - All Plans | $47 | 144% |
| Molina Benefit Exchange - All Other Plans | $49 | 150% |
| Php-Prospect Health Plan Cap - All Plans | $54 | 165% |
| Care First Medi-Cal | $61 | 186% |
| Ah Employee Health Plan - All Plans | $65 | 199% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $80 | 244% |
| Bella Vista Medi-Cal Op/Profee Only | $80 | 244% |
| Centivo - All Plans | $81 | 247% |
| Blue Shield Mcr Adv | $105 | 321% |
| Aetna | $108 | 330% |
| Pacific Ipa - All Other Plans | $143 | 437% |
| Caremore Mcare - All Plans | $154 | 471% |
| Kaiser- All Plans | $155 | 474% |
| Cigna | $159 | 486% |
| Healthnet - All Other Plans | $170 | 519% |
| Healthnet Comm Care | $176 | 538% |
| Hcpamg - All Plans | $189 | 577% |
| Healthcare Inc - All Other Plans | $207 | 632% |
| La Care Mcr Adv - All Plans | $207 | 632% |
| First Heatlh Ppo - All Plans | $219 | 669% |
| Phcs Ppo - All Plans | $245 | 749% |
| Scan Health Mcare - All Plans | $245 | 749% |
| Ahf - All Plans | $283 | 865% |
| Beech Street - All Plans | $283 | 865% |
| Interplan Ppo - All Plans | $283 | 865% |
| Corvel Corp - All Plans | $302 | 923% |
| Multiplan Ppo - All Plans | $313 | 956% |
| Healthmannet - All Plans | $320 | 978% |
| Next Inc Ppo - All Plans | $320 | 978% |
| Trpn - All Plans | $320 | 978% |
| Fpn Ppo - All Plans | $339 | 1036% |
| Western Growers/Pinnacle - All Plans | $341 | 1042% |
| Blue Shield Epn | $460 | 1405% |
| Blue Shield - All Other Plans | $530 | 1619% |
| Healthnet Mcr Adv | $577 | 1763% |