CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Portneuf Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $185
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 5.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Portneuf Medical Center is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.65x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$185

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: $176 (538%)
Insurance Median: $185 (565%)
Cash: $176 (538% of Medicare)
Ins. Median: $185 (565% 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 565% of the Medicare baseline (a markup of 465%). 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.

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
Bannock County Jail [6050] $35 - $65 107%
Department Of Corrections [1340] $35 - $65 107%
Medicaid / KanCare $35 - $65 107%
Pending County Rca [3910] $35 - $65 107%
UnitedHealthcare $35 - $344 107%
Aetna $42 - $324 128%
Healthscope Benefits [2290] $42 - $79 128%
Black Lung [6055] $84 - $157 257%
Employee Benefit Management Services [2445] $84 - $229 257%
Healthcare Highways [2210] $84 - $363 257%
Lucent Health [6000] $84 - $157 257%
Moda Health [6100] $84 - $157 257%
Oncology Patient Assistance Programs [2295] $84 - $157 257%
Pending Ssi [1616] $84 - $157 257%
Web Tpa [2115] $84 - $157 257%
Pacific Source Health Plans [2850] $118 - $220 361%
Liberty Health Share Lhs/Medcost Solutions Llc [2400] $123 - $229 376%
Medishare Christian Care [1645] $123 - $229 376%
Multiplan [1680] $138 - $363 422%
Worker'S Comp [2125] $150 - $287 458%
Enablecomp [1350] $154 - $287 471%
Transamerican Life [1990] $154 - $287 471%
First Health [1375] $170 - $315 519%
Mailhandlers [1595] $175 - $324 535%
Selecthealth [3740] $175 - $344 535%
Cigna $182 - $337 556%
Geha [1415] $185 - $344 565%
Humana $185 - $344 565%
Administrative Concepts [1005] $196 - $363 599%
Healthfirst [2395] $196 - $363 599%
Healthnet [1495] $196 - $363 599%
Hometown Health [2155] $196 - $363 599%
Mayo Clinic Health Solutions [2280] $196 - $363 599%
Meritain Health [1655] $196 - $363 599%
Mutual Of Omaha [1685] $196 - $363 599%
National Association Of Letter Carriers [1695] $196 - $363 599%
New Era Life Insurance Company [1705] $196 - $363 599%
Pan American Life Insurance Co [1770] $196 - $363 599%
Pba [1775] $196 - $363 599%
Phcs [1780] $196 - $363 599%
Planned Administrators Inc [2360] $196 - $363 599%
Trustmark [2030] $196 - $363 599%
Ut Id Teamsters [3760] $196 - $363 599%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 777 Hospital Way, Pocatello, ID 83201
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals