CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University of Colorado Hospital Authority

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $193
Cash Discount Price: $151
vs. Medicare Baseline: 5.90x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University of Colorado Hospital Authority is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.90x the Medicare baseline. Located in 12605 E 16Th Ave, Aurora, CO.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $151 (461%)

Insurance Median: $193 (590%)

Cash: $151 (461% of Medicare)

Ins. Median: $193 (590% 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 590% of the Medicare baseline (a markup of 490%). 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
UnitedHealthcare	$32 - $383	98%
Aetna	$33 - $212	101%
Blue Cross Blue Shield	$33 - $324	101%
Cigna	$33 - $223	101%
Cms	$33	101%
Denver Health Medical Plan	$33 - $228	101%
Devoted Health	$33	101%
Humana	$33	101%
Kaiser	$33 - $252	101%
Select Health	$33 - $90	101%
Rocky Mountain Health Plan	$140 - $219	428%
Simplified Benefits Administration	$166 - $203	507%
Kaiser Public Option	$168	513%
Phcs	$236	721%
Multiplan	$258	788%
First Health	$301	920%
Midlands Choice	$301	920%

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 $151.
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 Colorado Hospital 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.