CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University of Alabama Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $187
Cash Discount Price: Unavailable
vs. Medicare Baseline: 5.71x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University of Alabama Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.71x the Medicare baseline. Located in 619 South 19Th Street, Birmingham, AL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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%)

Insurance Median: $187 (571%)

Ins. Median: $187 (571% 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 571% of the Medicare baseline (a markup of 471%). 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
Viva	$11	34%
Triwest	$31	95%
University Of Alabama	$116	354%
UnitedHealthcare	$126 - $206	385%
Aetna	$141	431%
Coventry	$150 - $187	458%
North Alabama Managed Care	$150	458%
Cigna	$155 - $176	474%
Comp One	$166	507%
Alamed	$173	529%
Construction Claims Management	$173	529%
Corvel	$185	565%
Evolutions	$185 - $208	565%
Healthcare Alliance	$185	565%
Novanet	$185 - $208	565%
Prime Health Services	$185 - $208	565%
Select Value Care	$185	565%
Starcare	$185	565%
Tethys	$185	565%
Multiplan	$189	577%
Department Of Labor	$196	599%
Geha	$196	599%
Gulf Health Plans	$196	599%
Heritage Summit Health	$196	599%
Humana	$196	599%
Mississippi Physicians	$196	599%
Phifer	$196	599%
Preferred Health Partnership	$196	599%
Southern Nuclear	$196	599%
Vantage Health Plan	$196	599%
Galaxy Health Network	$208	636%
National Provider Network	$208	636%
North Mississippi Health Link	$208	636%

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 $X.
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 University of Alabama 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.