CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Gadsden Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $49
  • Cash Discount Price: $63
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Gadsden Regional Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.50x the Medicare baseline. Located in 1007 Goodyear Avenue, Gadsden, AL.
Cash / Self-Pay
$63

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $63 (192%)
Insurance Median: $49 (150%)
Cash: $63 (192% of Medicare)
Ins. Median: $49 (150% 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.

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
Tricare $28 86%
Blue Cross Blue Shield $30 92%
Humana $30 92%
Medicaid / KanCare $30 92%
Medicare (plans) $30 92%
Node Champva $30 92%
Node Select Health Mcr Adv $30 92%
Node Viva Mcr Adv $30 92%
Veterans Eval Services $30 92%
Aetna $31 - $218 95%
Amedisys Hospice $31 95%
Cigna $31 - $172 95%
Gadsden Hospice $31 95%
Node Clover Health Mcr Adv $31 95%
Node Devoted Health Mcr Adv $31 95%
Node Non Par Hospice Agree $31 95%
Node Va $31 95%
Node Wellcare Mcr Adv $31 95%
Southern Care Hospice $31 95%
UnitedHealthcare $31 - $200 95%
Node Eon Mcr Adv $32 98%
Prime Health $32 - $304 98%
Ambetter / Centene $46 141%
Node Us Dept Of Labor $48 147%
Self Pay $50 - $76 153%
Alamed Wc $53 162%
American Employee Alliance $168 513%
Multiplan $236 - $265 721%
Magellan Behavioral $252 770%
Viva Healthcare $252 770%
First Health $294 - $340 898%
Beech Street $307 - $1,525 938%
Focus Health $322 984%
Coventry Work Comp Al $329 1005%
Work Comp $358 1094%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1007 Goodyear Avenue, Gadsden, AL 35903
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals