CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Reedley

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $36
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health Reedley is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.
Cash / Self-Pay
$30

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: $30 (92%)
Insurance Median: $36 (110%)
Cash: $30 (92% 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
Bc Mcal $12 - $24 37%
Cal Viva Hlth Mcal - All Plans $12 - $18 37%
Central Ca Alliance Mcal Profee Only $12 37%
Dignity Mcal Op/Profee Only-All Other Plans $12 - $19 37%
Medi-Cal $12 - $18 37%
Upn Mcal Profee Only-All Other Plans $12 37%
Healthnet Medi-Cal $13 - $35 40%
Kern Health Systems Mcal-All Plans $15 - $18 46%
Central Ca Alliance Ccs Profee Only $18 55%
Central Ca Alliance Comm Profee Only - All Other P $18 55%
Community Care Ipa Mcal-All Plans $23 - $75 70%
Aetna $24 - $390 73%
Central Ca Alliance Chdp Profee Only $24 73%
Blue Shield Mcare $34 104%
Dignity Mcr Adv Op/Profee Only $34 104%
Fhcn Pace Mcr Adv-All Plans $34 104%
Healthnet- Mcr Adv $34 104%
Kaiser Mcr Adv $34 - $46 104%
Lasalle Med Assoc Profee Only - All Plans $34 104%
Phs Prime Health Srvcs $34 104%
Tricare $34 104%
UnitedHealthcare $34 - $301 104%
Upn Mcr Adv Profee Only $34 104%
Cigna $36 - $153 110%
Healthnet- All Other Plans $37 - $103 113%
Ah Employee Health Plan - All Plans $38 - $62 116%
Western Growers/Pinnacle- All Plans $39 - $109 119%
Kaiser - All Other Plans $42 - $118 128%
Blue Shield Epn - All Other Plans $44 - $128 134%
Blue Shield Non Epn $46 - $148 141%
Blue Cross Blue Shield $49 - $526 150%
Bright Health Mcr Adv - All Plans $54 165%
Physicians Med Group Op/Profee Only- All Plans $67 - $189 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 372 W Cypress Ave, Reedley, CA 93654
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals