CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Simi Valley

Billing Code: 97112 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$49

about 1.5× the $33 Medicare rate · typically $37–$173

modeled estimate · not a bill or quote

Medicare pays $33 Fair price $49 Cash price $41 Hospital's list price $257

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Kaiser Permanente Humana

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$36 - $203	110%
Blue Cross Blue Shieldmajor	$36 - $357	110%
Aetnamajor	$141	431%
Cignamajor	$153	467%
Kaiser Permanentemajor	$128	391%
Health Net	$199	608%
+ 15 smaller / regional plans	$22 - $536

Government programs also on file: Medicare, Military & VA.

Excludes 10 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 41), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 97112.

Insurance Before you use insurance

Call your insurance company to confirm Adventist Health Simi Valley is in-network.
Ask your insurer whether prior approval is required for CPT code 97112.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Adventist Health Simi Valley

Compare: Physical therapy (neuromuscular re-education) at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.