CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Thomas H Boyd Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $98
  • Cash Discount Price: $106
  • vs. Medicare Baseline: 2.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Thomas H Boyd Memorial Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.99x the Medicare baseline. Located in 800 School St, Carrollton, IL.
Cash / Self-Pay
$106

Average discount available for prompt cash payment at this facility.

Insurance Median
$98

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: $106 (324%)
Insurance Median: $98 (299%)
Cash: $106 (324% of Medicare)
Ins. Median: $98 (299% 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 299% of the Medicare baseline (a markup of 199%). 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
Aetna $67 - $187 205%
Blue Cross Blue Shield $67 - $187 205%
Health Alliance Mcr Adv $67 205%
UnitedHealthcare $67 - $182 205%
Wellcare Mcr Adv-All Plans $67 205%
Humana $68 208%
Health Alliance-All Other Plans $81 247%
Ambetter / Centene $88 269%
Cigna $94 287%
Multiplan-All Plans $99 302%
Healthlink Hmo $100 306%
Healthlink Il Only $100 306%
Healthlink Ppo-All Other Plans $114 348%
Hfn Zelis-All Plans $120 367%
Meridian Hp Mcaid-All Plans $187 571%
Molina Mcaid-All Plans $187 571%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 School St, Carrollton, IL 62016
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals