CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Encino Hospital Medical Center

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 Encino Hospital Medical Center 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 16237 Ventura Blvd, Encino, 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
Aids Healthcare Foundation $18 - $37 55%
Blue Cross Blue Shield $18 55%
Blue Shield Of Promise $18 - $36 55%
Health Net Of Ca $18 - $53 55%
La Care Health Plan $18 - $36 55%
Molina $18 - $36 55%
Traditional Medi-Cal $18 55%
Alignment $36 110%
Blue Shield Of Ca, Va $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%
Brand New Day $37 - $54 113%
Imperial Health Plan Ca $38 116%
Corvel $45 137%
Zelis Healthcare $45 137%
Aetna $46 141%
Americas Choice Provider Network $46 141%
Multiplan $46 141%
Prime Health Services, Inc. $46 141%
Three Rivers $46 141%
Healthsmart Preferred Care Network $47 144%
Provider Select $47 144%
Provider Network Of America $48 147%
Workers Comp $48 147%
Employer Direct Healthcare $51 156%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16237 Ventura Blvd, Encino, CA 91436
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals