CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: West Anaheim Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $36
  • Cash Discount Price: $36
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at West Anaheim Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 3033 W Orange Avenue, Anaheim, CA.
Cash / Self-Pay
$36

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: $36 (110%)
Insurance Median: $36 (110%)
Cash: $36 (110% 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
Caloptima $18 55%
Traditional Medi-Cal $18 55%
Health Net Of Ca $19 - $53 58%
Blue Cross Blue Shield $36 110%
Blue Shield Of Ca Triwest $36 110%
Central Health Plan $36 110%
Health Net Of Ca Mhn (Bh) $36 110%
Medicare (plans) $36 110%
Molina $36 110%
Renal Payor Solutions $36 110%
Tricare $36 110%
Verda Health Plan $36 110%
Brand New Day $37 - $54 113%
Imperial Health Plan Of Ca Inc $38 116%
Health Net Federal Services $45 137%
Aetna $46 141%
Ca Foundation For Medical Care $48 147%
Workers Compensation $48 147%
Employer Direct Healthcare Surgery Plus $51 156%
Naphcare (Santa Ana - County Jail) $56 171%
Naphcare Residential Treatment Center $56 171%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3033 W Orange Avenue, Anaheim, CA 92804
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals