CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Presence Mercy Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $35
  • Cash Discount Price: $33
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Presence Mercy Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$33

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $33 (101%)
Insurance Median: $35 (107%)
Cash: $33 (101% of Medicare)
Ins. Median: $35 (107% 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
Blue Cross Blue Shield $32 - $47 98%
Advocate Helath Partners $34 - $37 104%
Aetna $34 - $45 104%
Celtic (Wellcare) $34 104%
Cigna $34 104%
Clear Spring Health Of Illinois $34 104%
Devoted Health $34 104%
Essential Health Partners $34 - $39 104%
Health Alliance Medical Plan $34 104%
Humana $34 - $45 104%
Longevity Health Plan Of Illinois $34 104%
Medicare (plans) $34 104%
Ravenswood Physicians Associates Ipa $34 104%
Resurrection Physicians Provider Group Ipa $34 104%
Self-Pay $34 104%
Tricare $34 104%
United Behavioral Health $34 104%
UnitedHealthcare $34 - $42 104%
Meridian $35 - $48 107%
Molina $35 - $50 107%
Provider Partners Health Plan (Pphp) $35 107%
Zing Health Provider Network $35 107%
Harmony Health Plan $36 - $48 110%
Access Community Health Network $40 122%
Medicaid / KanCare $45 - $48 137%
Clifton Health Systems $52 159%
Ambetter / Centene $54 165%
Hfn Inc (Healthcare Finest Network) $102 312%
Corvel $104 318%
Coventry $104 318%
Workers Comp $104 318%
Imagine Health Network, Inc. $149 455%
Community Partners Health Plan $161 492%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals