CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Alta Vista Regional Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $235
Cash Discount Price: $147
vs. Medicare Baseline: 7.18x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Alta Vista Regional Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 7.18x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$235

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: $147 (449%)

Insurance Median: $235 (718%)

Cash: $147 (449% of Medicare)

Ins. Median: $235 (718% 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 718% of the Medicare baseline (a markup of 618%). 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
Commercial Hmo Ppo	$28 - $293	86%
Medicaid / KanCare	$30 - $293	92%
Php Centennial	$30	92%
Champus	$33 - $293	101%
Medicare (plans)	$36 - $293	110%
UnitedHealthcare	$41 - $47	125%
Mcare Mcaid Hmo Dual	$47	144%
Workers Comp	$120 - $293	367%
Self Pay	$147	449%
Other Covernment	$183 - $293	559%
Blue Cross Blue Shield	$220 - $293	672%
Mva	$293	895%
Other Government	$293	895%

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 $147.
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 Alta Vista Regional 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.