CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Ukiah Valley

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $71
Cash Discount Price: $31
vs. Medicare Baseline: 2.17x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health Ukiah Valley is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.17x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$31

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $31 (95%)

Insurance Median: $71 (217%)

Cash: $31 (95% of Medicare)

Ins. Median: $71 (217% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 217% of the Medicare baseline (a markup of 117%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Kaiser Medi-Cal	$12 - $18	37%
Medi-Cal	$12 - $18	37%
Aetna	$23 - $149	70%
Blue Shield Mcr Adv	$34	104%
Kaiser Mcr Adv	$34	104%
Tricare	$34	104%
UnitedHealthcare	$34 - $186	104%
Ah Employee Health Plan - All Plans	$38 - $62	116%
Blue Shield Epn-All Other Plans	$44 - $290	134%
Cigna	$44 - $174	134%
Blue Shield Non-Epn	$46 - $297	141%
Western Growers-All Plans	$49 - $309	150%
Healthnet-All Plans	$50 - $128	153%
Mendocino Lcc District-All Plans	$55 - $145	168%
Blue Cross Blue Shield	$66 - $634	202%
Kaiser-All Other Plans	$67 - $178	205%
Three Rivers-All Plans	$76 - $201	232%
Foundation For Medical Care-All Plans	$167	510%
Networks By Design-All Plans	$178	544%
Phcs Multiplan-All Plans	$178	544%
Interplan-All Plans	$183	559%
Beech Street-All Plans	$190	581%
Choice Care-All Plans	$190	581%
Health Mgmt Network-All Plans	$190	581%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $31.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Ukiah Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97112.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.