CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Medical Center Enterprise

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $32
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Medical Center Enterprise is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 400 N Edwards Street, Enterprise, AL.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $62 (189%)
Insurance Median: $32 (98%)
Cash: $62 (189% of Medicare)
Ins. Median: $32 (98% 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
Al Maternity Waiver Program $22 67%
Tricare $28 86%
Self Pay $29 - $96 89%
Blue Cross Blue Shield $30 - $51 92%
Humana $30 92%
Medicaid / KanCare $30 92%
Medicare (plans) $30 92%
Node Champva $30 92%
Select Health $30 92%
UnitedHealthcare $30 - $224 92%
Veterans Eval Services $30 92%
Aetna $31 - $224 95%
Covenant Hospice $31 95%
Dayspring Hospice $31 95%
Healthspring $31 95%
Node Clover Mcr Adv $31 95%
Node Devoted Health Mcr Adv $31 95%
Node Hospice Non Par $31 95%
Node Va $31 95%
Node Wellcare Mcr Adv $31 95%
Southerncare Hospice $31 95%
Wiregrass Hospice $31 95%
Eon Health $32 98%
Cigna $33 - $198 101%
Ambetter / Centene $46 141%
Node Us Dept Of Labor $48 147%
Occunet $65 199%
American Employee Alliance $128 391%
Alamed $192 587%
Affordable Health $224 684%
Health Choice $224 684%
Novanet Ppo $224 684%
Coventry Work Comp Al $235 718%
Multiplan $236 - $252 721%
Wc Dept Ind Relations $256 782%
Corvel $272 831%
Galaxy Health $288 880%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 N Edwards Street, Enterprise, AL 36330
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals