Physical therapy (neuromuscular re-education)
Facility: North Shore Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $76
- Cash Discount Price: $416
- vs. Medicare Baseline: 2.32x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 232% of the Medicare baseline (a markup of 132%). 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.
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 | $12 - $314 | 37% |
| Veterans Administration Mill Bill | $23 | 70% |
| Medicare (plans) | $29 - $436 | 89% |
| Humana | $31 - $75 | 95% |
| Devoted Health | $32 | 98% |
| Leon Health Inc | $32 | 98% |
| UnitedHealthcare | $32 - $364 | 98% |
| Employer Direct Healthcare | $33 - $41 | 101% |
| Hospice Other | $33 | 101% |
| Veterans Administration Vaccn | $33 | 101% |
| Cigna | $34 - $218 | 104% |
| Healthsun Health Plans | $34 | 104% |
| Tricare | $34 | 104% |
| Longevity Health Plan | $35 | 107% |
| Dimension Health Wc | $39 | 119% |
| Florida Pace Centers | $39 | 119% |
| Workers Compensation | $39 | 119% |
| Bright Health Management Commercial | $40 | 122% |
| Centurion Prison | $40 | 122% |
| Self Pay/Uninsured | $40 | 122% |
| Bc/Bs Myblue Hmo Hix | $53 - $58 | 162% |
| Bc/Bs Of Fl Health Options Hmo | $57 - $63 | 174% |
| Bc/Bs Of Fl Ppo | $57 - $63 | 174% |
| Bc/Bs Of Fl Simplyblue | $57 - $63 | 174% |
| Avmed Exchange | $58 | 177% |
| Ambetter / Centene | $61 | 186% |
| Bc/Bs Of Fl Network Blue | $61 - $67 | 186% |
| Molina Marketplace Program Exchange | $63 | 192% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $64 - $71 | 196% |
| Auto Insurance | $66 | 202% |
| Avmed Select Network | $67 | 205% |
| Amerihealth Caritas Next Exchange | $71 | 217% |
| Medicaid / KanCare | $99 - $436 | 302% |
| Oscar Health Plan Hix | $114 | 348% |
| Imagine Health | $161 | 492% |
| Avmed Broad Network | $171 | 522% |
| Bc/Bs Of Fl Phs | $206 - $226 | 629% |
| Magellan Behavioral Health | $238 - $262 | 727% |
| Dimensions International | $258 - $283 | 788% |
| First Health | $270 - $296 | 825% |
| Dimension Health Ppo | $298 - $327 | 910% |
| Beacon Health Strategies Commercial | $397 - $436 | 1213% |
| Commercial Non-Contracted | $397 - $436 | 1213% |
| Self Pay - Mcd Pending 100 Percent | $397 - $436 | 1213% |
| Single Case Agreement | $397 - $436 | 1213% |
| United Behavioral Health Psych | $397 - $436 | 1213% |