CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Twin Cities

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $280
Cash Discount Price: $28
vs. Medicare Baseline: 8.55x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health Twin Cities is $280. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $28. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 8.55x the Medicare baseline. Located in 1100 Las Tablas Rd, Templeton, CA.

Cash / Self-Pay

$28

Average discount available for prompt cash payment at this facility.

Insurance Median

$280

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: $28 (86%)

Insurance Median: $280 (855%)

Cash: $28 (86% of Medicare)

Ins. Median: $280 (855% 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 855% of the Medicare baseline (a markup of 755%). 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
Aetna	$35 - $474	107%
Cencal Mcr Adv - All Other Plans	$35	107%
Tricare	$35	107%
UnitedHealthcare	$35 - $431	107%
Cfmg-Ca Forensic Med Grp Op/Profee Only-All Plans	$46	141%
Ah Employee Health Plan - All Plans	$63	192%
Hpn-Heritage Prov Ntwrk-All Plans	$104 - $163	318%
Chn-Community Hlth Ntwrk-All Plans	$168 - $264	513%
Nbd-Ntwrks By Design Exlus-All Other Plans	$177 - $277	541%
Nbd-Ntwrks By Design Non-Exlus	$177 - $277	541%
Blue Shield Epn	$244	745%
Pacific Health Alliance-All Plans	$275 - $432	840%
Blue Shield Hmo/Pos	$280	855%
Medi-Cal	$306 - $480	935%
Blue Shield Epo/Ppo - All Other Plans	$329	1005%
Cencal Mcal	$349 - $547	1066%
Blue Shield Promise Mcal	$368 - $577	1124%
Ccah-Centrl Ca Allince Mcal-All Plans	$398 - $624	1216%
Coalinga-All Plans	$398 - $624	1216%

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 $28.
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 Twin Cities 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.