CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Adventist Health Tehachapi Valley

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $51
Cash Discount Price: $35
vs. Medicare Baseline: 1.56x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Adventist Health Tehachapi Valley is $51. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $35. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.56x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$35

Average discount available for prompt cash payment at this facility.

Insurance Median

$51

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: $35 (107%)

Insurance Median: $51 (156%)

Cash: $35 (107% of Medicare)

Ins. Median: $51 (156% 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
Medi-Cal	$12 - $18	37%
Universal Ipa Mcal Op/Profee Only	$12 - $18	37%
Bc Mcal	$18	55%
Kaiser Medi-Cal Ip/Op Only	$18	55%
Healthnet Medi-Cal	$22	67%
Aetna	$23 - $112	70%
Khs-Kern Hlth Systm Mcal	$23	70%
Healthnet Mcare	$25 - $54	76%
Medicare (plans)	$25 - $54	76%
Tricare	$25 - $54	76%
UnitedHealthcare	$25 - $139	76%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$25 - $54	76%
Network Providers- All Plans	$32 - $69	98%
Cigna	$36 - $221	110%
Ah Employee Health Plan - All Plans	$38 - $150	116%
Oscar Health Plan- All Plans	$40 - $55	122%
Coventry- All Plans	$41 - $255	125%
Kaiser Ip/Op Only- All Other Plans	$42 - $92	128%
Blue Shield Epn- All Other Plans	$44 - $98	134%
Klhp-Kern Legacy Epo -All Other Plans	$44 - $55	134%
Blue Shield Non-Epn	$46 - $171	141%
Western Grwrs/Pinnacle - All Plans	$48 - $119	147%
Blue Cross Blue Shield	$49 - $172	150%
Healthnet- All Other Plans	$50 - $218	153%
Centivo - All Plans	$52 - $121	159%

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 $35.
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 Tehachapi 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.