CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: The East Alabama Healthcare Authority

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $62
Cash Discount Price: $42
vs. Medicare Baseline: 1.89x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at The East Alabama Healthcare Authority is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.89x the Medicare baseline. Located in 2000 Pepperell Parkway, Opelika, AL.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$62

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: $42 (128%)

Insurance Median: $62 (189%)

Cash: $42 (128% of Medicare)

Ins. Median: $62 (189% 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
Novanet	$11 - $12	34%
Aetna	$30 - $77	92%
Blue Cross Blue Shield	$30 - $49	92%
Cigna	$30	92%
Humana	$30 - $63	92%
Simpra	$30	92%
Viva	$30 - $69	92%
Beechstreet	$31 - $65	95%
Alabama Crime Victims	$38	116%
Mcm Maxcare	$60 - $62	183%
Mega Life	$60 - $62	183%
UnitedHealthcare	$60 - $62	183%
Coventry First Health	$64 - $65	196%
Geha	$64 - $65	196%
Multiplan	$64 - $65	196%
Workers Comp	$64 - $65	196%
Trpn	$68 - $69	208%

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 $42.
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 The East Alabama Healthcare Authority 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.