CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ventura County Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $47
  • Cash Discount Price: $142
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ventura County Medical Center is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.44x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$142

Average discount available for prompt cash payment at this facility.

Insurance Median
$47

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: $142 (434%)
Insurance Median: $47 (144%)
Cash: $142 (434% of Medicare)
Ins. Median: $47 (144% 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
Hpn Ip/Op Only Medi-Cal $18 55%
Kaiser Medi-Cal Ip/Op Only $18 55%
Medi-Cal $18 55%
Kaiser Mcal Pediatric Ip/Op Only $19 58%
Clinicas Mcal $22 67%
Americas Hp Mcal Ip/Op Only $23 70%
Gold Coast Medi-Cal-All Plans $31 95%
Tricare $35 107%
Alignment Hp - All Plans $36 110%
Blue Shield Mcr Adv $36 110%
Humana $36 110%
UnitedHealthcare $37 - $155 113%
Healthnet Mcr Adv $38 116%
Americas Hp Mcr Adv Ip/Op Only $41 125%
Clinicas Mcr Adv $41 125%
Scan-All Plans $43 131%
Western Growers-All Plans $45 137%
Clinicas Comm - All Other Plans $47 144%
Imperial-All Plans $47 144%
Ntwrk Provdrs-All Plans $47 144%
Americas Hp Comm Ip/Op Only-All Other Plans $54 165%
Vchcp-All Plans $54 165%
Blue Shield Epn $110 336%
Cigna $148 452%
Healthnet Comm-All Other Plans $156 477%
Kaiser Comm Pediatric Ip/Op Only $156 477%
Aetna $165 - $284 504%
Blue Shield Comm - All Other Plans $172 526%
Multiplan/Claritev-All Plans $227 694%
Three Rivers Ip/Op Only-All Plans $227 694%
Blue Cross Blue Shield $234 715%
Ppo Next Ip/Op Only-All Plans $256 782%
Kaiser Mcr Pediatric Ip/Op Only $284 868%
Medicare (plans) $284 868%
Hpn Comm Ip/Op Only-All Other Plans $403 1231%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals