CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Humboldt County Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $47
Cash Discount Price: $55
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Humboldt County Memorial Hospital is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.44x the Medicare baseline. Located in 1000 North 15Th Street, Humboldt, IA.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $55 (168%)

Insurance Median: $47 (144%)

Cash: $55 (168% of Medicare)

Ins. Median: $47 (144% 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	$43 - $46	131%
Great West	$43	131%
Health Partners	$43 - $49	131%
Physicians Mutual	$44	134%
Cigna	$46	141%
Phcs	$46	141%
Blue Cross Blue Shield	$47 - $53	144%
Humana	$47 - $52	144%
Iowa Health	$47	144%
Molina	$47 - $61	144%
Deanhealth	$49	150%
UnitedHealthcare	$59	180%
Wellpoint	$59 - $61	180%
Iowa Total Care	$61	186%

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 $55.
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 Humboldt County Memorial 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.