CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Yuma District Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $176
Cash Discount Price: $150
vs. Medicare Baseline: 5.38x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Yuma District Hospital is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $150. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.38x the Medicare baseline. Located in 1000 W 8Th Ave, Yuma, CO.

Cash / Self-Pay

$150

Average discount available for prompt cash payment at this facility.

Insurance Median

$176

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: $150 (458%)

Insurance Median: $176 (538%)

Cash: $150 (458% of Medicare)

Ins. Median: $176 (538% 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 538% of the Medicare baseline (a markup of 438%). 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
Medrisk_Preferred___Plan_	$65	199%
Align_Networks___Plan_	$70	214%
Aetna	$109 - $187	333%
Blue Cross Blue Shield	$109 - $175	333%
Corvel___Plan_	$148 - $152	452%
Friday_Health_Plan___Plan_	$168 - $173	513%
Medicare (plans)	$168 - $173	513%
Rocky_Mountain_Health_Plan___Plan_	$168 - $173	513%
Triwest___Plan_	$168 - $173	513%
Three_Rivers___Plan_	$178 - $183	544%
United_Healthcare___Plan_	$184 - $189	562%
Cigna	$188 - $193	574%
Cofinity_Preferred___Plan_	$188 - $193	574%
Uc_Health_Plan___Plan_	$188 - $193	574%
Humana	$192 - $197	587%
Midlands_Choice___Plan_	$192 - $197	587%
Multiplan_Open_Access___Plan_	$192 - $197	587%
Multiplan_Ppo___Plan_	$192 - $197	587%

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 $150.
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 Yuma District 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.