CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Desert Valley Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $34
Cash Discount Price: $34
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Desert Valley Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 16850 Bear Valley Rd, Victorville, CA.

Cash / Self-Pay

$34

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $34 (104%)

Insurance Median: $34 (104%)

Cash: $34 (104% of Medicare)

Ins. Median: $34 (104% 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.

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
Blue Shield Of Promise	$18 - $34	55%
Heritage Victor Valley Medical Group	$18 - $45	55%
High Desert Pace	$18 - $34	55%
Molina	$18 - $34	55%
Traditional Medi-Cal	$18	55%
Vantage Care	$18 - $34	55%
Health Net Of Ca	$19 - $51	58%
Inland Empire Health Plan	$25 - $43	76%
Aetna	$34 - $44	104%
Alignment	$34	104%
Blue Cross Blue Shield	$34 - $149	104%
Blue Shield Of Ca	$34 - $58	104%
Choice Physicians Network	$34	104%
Elite Health Plan	$34	104%
Epic Health Plan	$34	104%
High Desert Primary Care	$34	104%
Inland Empire Foundation For Medical Care	$34	104%
Medicare (plans)	$34	104%
Renal Payor Solutions	$34	104%
The Geo Group Inc	$34	104%
Tricare	$34	104%
UnitedHealthcare	$34	104%
Brand New Day	$35 - $52	107%
Imperial Health Plan Of Ca	$37	113%
Wellpath	$41	125%
Prime Health Services Inc	$44	134%
Workers Compensation	$45	137%
Employer Direct Healthcare	$48	147%
Naphcare	$48	147%

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 $34.
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 Desert Valley Hospital 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.