CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University of Iowa Hospital & Clinics

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $136
Cash Discount Price: $156
vs. Medicare Baseline: 4.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University of Iowa Hospital & Clinics is $136. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.16x the Medicare baseline. Located in 200 Hawkins Drive, Iowa City, IA.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$136

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: $156 (477%)

Insurance Median: $136 (416%)

Cash: $156 (477% of Medicare)

Ins. Median: $136 (416% 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 416% of the Medicare baseline (a markup of 316%). 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
Iowa Total Care	$26 - $32	79%
Molina Healthcare	$26 - $30	79%
Wellpoint (Amerigroup)	$26 - $32	79%
Aetna	$30 - $181	92%
Medical Associates	$30 - $157	92%
UnitedHealthcare	$30 - $179	92%
Blue Cross Blue Shield	$31 - $113	95%
Healthpartners	$31 - $200	95%
American Health Plan	$32 - $118	98%
Immergrun	$37 - $59	113%
Quad City Community Healthcare	$50 - $176	153%
Aplos Health Plan	$80 - $188	244%
Midlands Choice	$84 - $153	257%
Oscar Health	$93 - $148	284%
Great River Health Systems	$104 - $164	318%
Sedgwick	$118 - $188	361%
Global Excel	$126 - $200	385%
Sanford Health Plan	$126 - $200	385%
Employee Benefit Systems	$130 - $212	397%
Sisco	$130 - $207	397%
Healthsmart	$133 - $212	406%
Hfn	$136 - $216	416%
Multiplan	$136 - $216	416%

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 $156.
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 University of Iowa Hospital & Clinics 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.