CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Snoqualmie Valley Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $107
Cash Discount Price: $136
vs. Medicare Baseline: 3.27x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Snoqualmie Valley Hospital is $107. 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 3.27x the Medicare baseline. Located in 9801 Frontier Ave Se, Snoqualmie, WA.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $107 (327%)

Cash: $136 (416% of Medicare)

Ins. Median: $107 (327% 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 327% of the Medicare baseline (a markup of 227%). 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	$96 - $139	293%
Amerigroup Wellpoint	$96 - $119	293%
Community Health Plan Of Wa	$96 - $103	293%
Medicare (plans)	$96 - $101	293%
Molina Healthcare Of Washington Mcr Adv	$96 - $101	293%
Blue Shield Of Wa Regence Mcr Adv	$97 - $102	296%
Humana	$97 - $102	296%
Molina Healthcare Of Washington	$98 - $103	299%
UnitedHealthcare	$98 - $221	299%
Washington Coordinated Care	$98 - $121	299%
Community Health Plan Of Wa Mcd Rep	$107 - $112	327%
Medicaid / KanCare	$107 - $112	327%
Molina Healthcare Of Washington Mcd Rep	$115 - $121	351%
Blue Cross Blue Shield	$137 - $144	419%
Blue Shield Of Wa Regence	$137 - $144	419%
Kaiser Foundation Health Plan Of The Northwest	$144 - $151	440%
First Choice Health Network	$160 - $168	489%
Cigna	$183 - $192	559%

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 $136.
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 Snoqualmie 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.