CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: St Luke's Nampa Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $65
Cash Discount Price: $81
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at St Luke's Nampa Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.99x the Medicare baseline. Located in 9850 West St Lukes Drive, Nampa, ID.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $81 (247%)

Insurance Median: $65 (199%)

Cash: $81 (247% of Medicare)

Ins. Median: $65 (199% 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
UnitedHealthcare	$33 - $66	101%
Blue Cross Blue Shield	$52 - $82	159%
Commercial [1028]	$52 - $82	159%
Mountain Health Co-Op [1067]	$52 - $53	159%
Pacificsource [1020]	$52 - $61	159%
Select Health [1063]	$52 - $82	159%
Slplan Tap Mc St Lukes Health Plan [1641000001]	$52 - $82	159%
St Lukes Health Plan [1046]	$52 - $82	159%
Aetna	$65 - $73	199%
Cigna	$65	199%
Providence [1022]	$65	199%
Webtpa [1071]	$65 - $69	199%
Geha [1065]	$66	202%
United Medical Resources [1051]	$66	202%
First Health [1064]	$67 - $69	205%
Moda [1055]	$71	217%
Regence [1005]	$77 - $81	235%
Blue Shield Alt [100401]	$81	247%
Regence Out Of State [1004]	$81	247%

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 $81.
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 St Luke's Nampa 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.