CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Lodi Memorial

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $43
  • Cash Discount Price: $15
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health Lodi Memorial is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.31x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$15

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $15 (46%)
Insurance Median: $43 (131%)
Cash: $15 (46% of Medicare)
Ins. Median: $43 (131% 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%
Celtic Ins Company - All Plans $12 - $20 37%
Kaiser Mcal $12 - $18 37%
Medi-Cal $12 - $18 37%
Hp Mcal Pro Fee $13 40%
Healthnet Mcal $15 - $25 46%
Hp Of San Joaquin Mcal $15 - $22 46%
Medcore(Omni Ipa) Op Only- All Plans $22 - $89 67%
Blue Shield Epn - All Other Plans $27 - $110 82%
Aetna $28 - $102 86%
Blue Shield Non-Epn $28 - $115 86%
Alignment Health Plan (Ahp)-All Plans $34 104%
Blue Shield Mcare Adv $34 104%
Cca Health Plan Mcr Adv- All Plans $34 104%
Healthnet Mcare $34 104%
Hp Of San Joaquin Mcr Adv $34 104%
Humana $34 104%
Kaiser Commercial - All Other Plans $34 - $140 104%
Kaiser Mcr Adv $34 - $46 104%
Knnex Health - All Plans $34 - $41 104%
Tricare $34 104%
UnitedHealthcare $34 - $203 104%
Cigna $36 - $307 110%
Hp Healthy Kids Pro Fee $36 110%
Ah Employee Health Plan - All Plans $38 - $62 116%
First Health- All Plans $41 - $280 125%
Healthnet- All Other Plans $41 - $167 125%
Networks By Design- All Plans $42 - $170 128%
Beech Street- All Plans $45 - $307 137%
Hp Of San Joaquin Ppo - All Other Plans $45 - $324 137%
Multiplan- All Plans $45 - $273 137%
Blue Cross Blue Shield $49 - $499 150%
Western Growers- All Plans $49 - $435 150%
Bright Health - All Plans $69 211%
Three Rivers Provider Network- All Plans $76 - $307 232%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals