CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: AHMC Anaheim Regional Medical Center
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $36
- Cash Discount Price: $213
- vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at AHMC Anaheim Regional Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 1111 W La Palma Avenue, Anaheim, CA.
Cash / Self-Pay
$213
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: $213 (651%)
Insurance Median: $36 (110%)
Cash: $213 (651% 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
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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 |
|---|---|---|
| Allied Physicians | $10 - $54 | 31% |
| Applecare Medical Group | $10 | 31% |
| Heritage Provider Network | $10 - $49 | 31% |
| Non Contracted Medi-Cal | $10 | 31% |
| Talbert Medical Group | $10 - $55 | 31% |
| Ahmc Reciprocity Agreement | $12 - $64 | 37% |
| Altamed Health Network | $12 - $36 | 37% |
| Beverly Hospital | $12 - $40 | 37% |
| Brand New Day | $12 - $45 | 37% |
| Health Net | $12 | 37% |
| Healthcare Partners | $12 - $36 | 37% |
| Healthy Way La | $12 | 37% |
| Aids Health Foundation | $14 - $36 | 43% |
| Avanti | $14 - $43 | 43% |
| Caloptima | $14 - $36 | 43% |
| Emanate Health | $14 - $45 | 43% |
| Health Net Inc | $14 - $164 | 43% |
| Healthnet Cal Optima Medi-Cal/Healthy Families | $14 | 43% |
| Hollywood Presbyterian Advanced Med Mgmt Mcal | $14 | 43% |
| Hollywood Presbyterian Medpoint Mcal | $14 | 43% |
| Medi-Cal | $14 | 43% |
| Monarch Health Plan | $14 - $145 | 43% |
| Prospect Health Plan | $17 - $49 | 52% |
| Kaiser Foundation Hospitals | $18 - $36 | 55% |
| Medical Safety Net Program | $18 | 55% |
| Veterans Administration | $25 | 76% |
| Angels Baseball Workers Comp | $28 | 86% |
| Interplan | $30 - $149 | 92% |
| First Health | $32 - $181 | 98% |
| Orange County Preferred Provider Organization | $32 - $160 | 98% |
| Prospect Medical Group | $32 | 98% |
| Athens Administrators | $33 | 101% |
| Capp Care | $33 - $160 | 101% |
| Cigna | $33 - $530 | 101% |
| Corvel | $33 - $160 | 101% |
| Marriot Intl | $33 | 101% |
| Non Contracted Workers Comp | $33 | 101% |
| Alta Los Angeles Hospital | $34 | 104% |
| Tricare | $34 | 104% |
| Aetna | $36 - $102 | 110% |
| Alignment Health Plan | $36 | 110% |
| Apa Aco Inc | $36 | 110% |
| Blue Cross Blue Shield | $36 - $75 | 110% |
| Blue Shield Of California | $36 - $355 | 110% |
| California Health Plan | $36 | 110% |
| Central Health Of California | $36 | 110% |
| Cv-19 Hrsa Uninsured Testing And Tx I/P And O/P | $36 | 110% |
| Davita Heatlhcare Partners Plan Inc | $36 - $115 | 110% |
| Healthnet | $36 | 110% |
| Humana | $36 | 110% |
| Innovative Integrated Health (Iih)/Orange County Pace | $36 | 110% |
| Medicare (plans) | $36 - $106 | 110% |
| Monarch Healthcare Medical Group | $36 | 110% |
| Pacificare | $36 | 110% |
| Private Pay Flat Rate | $36 | 110% |
| Scan Health Plan | $36 | 110% |
| Self-Pay | $36 | 110% |
| Seoul Medical Group | $36 | 110% |
| Wellcare | $36 | 110% |
| Nchp | $37 | 113% |
| Align Senior Care | $38 | 116% |
| Affiliated Doctors Of Orange County | $45 | 137% |
| Ahmc Health Self-Insurance Epo | $45 | 137% |
| Knox-Keene Act | $45 | 137% |
| Netcare Life And Health Insurance | $53 | 162% |
| Advance Clinical Research Institute | $64 | 196% |
| Msi/Medical Services For Indigents | $75 | 229% |
| Medical Acquisition Company | $85 | 260% |
| Memorial Healthcare Ipa | $100 | 306% |
| Healthcare Partners Commercial | $115 | 351% |
| Huntington Memorial Hospital | $115 | 351% |
| Genesis Healthcare Ipa Ancillary | $128 | 391% |
| Affiliated Health Fund | $149 | 455% |
| Allnet Preferred Provider | $149 | 455% |
| Care First | $149 | 455% |
| Private Healthcare Systems | $149 | 455% |
| Choicecare | $160 | 489% |
| Multiplan Inc | $160 | 489% |
| National Provider Network | $170 | 519% |
| Three Rivers Providers Network | $170 | 519% |
| Health Payors Organization | $192 | 587% |
| UnitedHealthcare | $198 - $344 | 605% |
| Non Contracted Commercial | $213 | 651% |
| Memorial Healthcare Ipa/Cap/Valuation Rates | $1,403 | 4287% |