CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Healthone Rose

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $67
  • Cash Discount Price: $259
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Healthone Rose is $67. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $259. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.05x the Medicare baseline. Located in 4567 E 9Th Ave, Denver, CO.
Cash / Self-Pay
$259

Average discount available for prompt cash payment at this facility.

Insurance Median
$67

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: $259 (791%)
Insurance Median: $67 (205%)
Cash: $259 (791% of Medicare)
Ins. Median: $67 (205% 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 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $30 - $144 92%
Blue Cross Blue Shield $30 - $201 92%
Bright Health $30 - $82 92%
Cigna $30 - $174 92%
Devoted Health $30 - $34 92%
Humana $30 - $34 92%
Innovage Pace $30 - $35 92%
Kaiser $30 - $71 92%
Mutual Of Omaha $30 - $34 92%
Rocky Mountain Health $30 - $34 92%
Total Longterm Care $30 - $34 92%
Triwest Health Alliance $30 - $34 92%
United $30 - $122 92%
Delaware Life Insurance $31 - $36 95%
Wellcare $31 - $35 95%
Vail Health $37 - $41 113%
Colorado Program For Children With Special Needs $109 - $122 333%
Western Plains Community Health $158 - $177 483%
Multiplan $170 - $245 519%
Northcare $170 - $190 519%
Physician Health Partners $170 - $190 519%
Pinnacol Workers Comp $182 - $204 556%
Medical Development International $194 - $218 593%
Rocky Mtn Planned Parenthood $207 - $231 632%
Prime Health $219 - $245 669%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4567 E 9Th Ave, Denver, CO 80220
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals