CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Jefferson County Health Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $48
  • Cash Discount Price: $62
  • vs. Medicare Baseline: 1.47x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Jefferson County Health Center is $48. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.47x the Medicare baseline. Located in 2000 S Main, Fairfield, IA.
Cash / Self-Pay
$62

Average discount available for prompt cash payment at this facility.

Insurance Median
$48

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: $62 (189%)
Insurance Median: $48 (147%)
Cash: $62 (189% of Medicare)
Ins. Median: $48 (147% 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.

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
UnitedHealthcare $35 - $94 107%
Tricare $40 122%
Amerigroup Mcr Adv $42 128%
Humana $42 128%
Iowa Total Care Comm - All Other Plans $42 128%
Iowa Total Care Mcr $42 128%
Molina Mcr Adv $42 128%
Iowa Total Care Mcaid $44 134%
Molina Mcaid/Chip $44 134%
Medicaid / KanCare $45 137%
Aetna $51 - $94 156%
Medicare (plans) $51 156%
Midlands New Product $85 260%
Coventry Commercial Hmo $88 269%
Coventry Commercial Ppo - All Other Plans $94 287%
Midlands Choice-All Other Plans $94 287%
Molina Marketplace - All Other Plans $104 318%
Wellmark Hmo $108 330%
Wellmark Indemnity/Ppo - All Other Plans $119 364%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 S Main, Fairfield, IA 52556
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals