CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Southern Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $34
Cash Discount Price: $33
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Southern Regional Medical Center is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 11 Upper Riverdale Road, Sw, Riverdale, GA.

Cash / Self-Pay

$33

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $33 (101%)

Insurance Median: $34 (104%)

Cash: $33 (101% of Medicare)

Ins. Median: $34 (104% 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.

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
Aetna	$23 - $33	70%
Humana	$31 - $66	95%
Americas Choice Provider Network	$33	101%
Blue Cross Blue Shield	$33 - $177	101%
Cigna	$33 - $56	101%
Clear Spring Health Plan	$33	101%
Corvel	$33	101%
Georgia Workers’ Compensation	$33	101%
Medicare (plans)	$33	101%
Multiplan	$33	101%
Novanet	$33	101%
Prime Health Services	$33	101%
Provider Select	$33	101%
Riverwood Behavioral Health	$33 - $41	101%
Three Rivers	$33	101%
Tricare	$33	101%
UnitedHealthcare	$33	101%
Caresource	$34 - $58	104%
Devoted Health	$34	104%
Peach State	$34 - $40	104%
Sonder Health Plan	$35	107%
Wellcare	$35	107%
Oscar Health Plan	$43	131%
Employer Direct Healthcare	$46	141%
Centurion	$50	153%
Naphcare	$51	156%
Therapy Network Of Ga	$196 - $234	599%

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 $33.
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 Southern Regional Medical Center 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.