CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Craig Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $170
  • Cash Discount Price: $94
  • vs. Medicare Baseline: 5.19x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Craig Hospital is $170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $94. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.19x the Medicare baseline. Located in 3425 S Clarkson St, Englewood, CO.
Cash / Self-Pay
$94

Average discount available for prompt cash payment at this facility.

Insurance Median
$170

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: $94 (287%)
Insurance Median: $170 (519%)
Cash: $94 (287% of Medicare)
Ins. Median: $170 (519% 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 519% of the Medicare baseline (a markup of 419%). 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
Veterans Administration $28 86%
Cms $33 101%
UnitedHealthcare $33 - $866 101%
Kaiser $120 - $133 367%
Blue Cross Blue Shield $122 - $136 373%
Cigna $125 - $161 382%
Carisk Outcomes $127 - $141 388%
Zenith $138 - $153 422%
Aetna $144 - $160 440%
Corvel Worker'S Comp $148 - $165 452%
Liberty Mutual Worker'S Comp $148 - $165 452%
Paradigm $148 - $165 452%
Rocky Mountain Health Plan $155 - $172 474%
Midwest Employers Casualty $157 - $174 480%
Coventry/First Health $159 - $176 486%
Fcci Worker'S Comp $159 - $176 486%
Geha/Ppo Usa $159 - $176 486%
Great-West Healthcare $159 - $176 486%
Prime Health Services $161 - $179 492%
First Choice Health $165 - $184 504%
Multiplan/Phcs $167 - $186 510%
Focus Worker'S Comp $169 - $188 516%
General Reinsurance $169 - $200 516%
Provider Network Of America $169 - $188 516%
Three Rivers Provider Network $169 - $193 516%
Wyoming Worker'S Comp $169 - $188 516%
Allstate $180 - $200 550%
Tricare $180 - $200 550%
National Provider Network $191 - $212 584%
Up & Up $191 - $212 584%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3425 S Clarkson St, Englewood, CO 80113
  • CMS Rating: No CMS Rating
  • Ownership Type: N/A
  • Hospital Type: PART A PROVIDER - HOSPITAL