CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Valley Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $98
  • Cash Discount Price: $136
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Valley Medical Center is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.99x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$136

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $136 (416%)
Insurance Median: $98 (299%)
Cash: $136 (416% of Medicare)
Ins. Median: $98 (299% 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 299% of the Medicare baseline (a markup of 199%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Humana $36 110%
UnitedHealthcare $36 - $98 110%
Regence Blue Shield [170100] $47 - $50 144%
Regence Uniform [130111] $48 147%
Blue Cross Blue Shield $50 - $54 153%
Regence Hma [170105] $50 153%
Regence Hma1 [170102] $50 153%
Bh United [180100] $51 156%
Aetna $86 263%
Benefit Md [150113] $98 299%
Carpenters Trust [150122] $98 299%
Cement Masons And Plasterers [150127] $98 299%
Coresource [150109] $98 299%
Employee Benefit Management Services [150108] $98 299%
Fc Moda Health [150139] $98 299%
First Choice Health Administrators [150110] $98 299%
First Choice Health Comp [150112] $98 299%
First Choice [150134] $98 299%
Health Net [150111] $98 299%
Here [150114] $98 299%
Hotel Employees Health Trust [150115] $98 299%
International Longshore & Warehouse Union [150116] $98 299%
Kitsap Physician Services [150118] $98 299%
Loomis Benefits West [150119] $98 299%
Mega [150120] $98 299%
Midwest [150121] $98 299%
Nw Administrators [150123] $98 299%
Operating Engineers [150125] $98 299%
Painters Trust [150126] $98 299%
Puget Sound Electric [150131] $98 299%
Seattle Plumb And Pipe [150132] $98 299%
Trusteed Plan [150101] $98 299%
United Employee Benefit Trust [150137] $98 299%
Washington Bakers Trust [150102] $98 299%
Washington Employers Trust [150103] $98 299%
Washington State Health Ins Pool [150104] $98 299%
Welfare Pension Administration Services [150105] $98 299%
Zenith Admin [150106] $98 299%
Zzjohn Alden [150117] $98 299%
Zzprincipal Financial Group [150128] $98 299%
Zzprovidence [150129] $98 299%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals