CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Hammond Henry Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $101
Cash Discount Price: $122
vs. Medicare Baseline: 3.09x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Hammond Henry Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $122. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.09x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$122

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $122 (373%)

Insurance Median: $101 (309%)

Cash: $122 (373% of Medicare)

Ins. Median: $101 (309% 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 309% of the Medicare baseline (a markup of 209%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$35	107%
Aetna	$39 - $101	119%
Health Alliance Mcare Adv	$39	119%
UnitedHealthcare	$39 - $133	119%
Wellmark Of Ia-All Plans	$68	208%
Blue Cross Blue Shield	$74 - $86	226%
Meridian Health Plan-All Plans	$86	263%
Springfield Armory-All Plans	$88	269%
Quad City Community Hc-All Plans	$90	275%
Ambetter / Centene	$94	287%
Health Alliance-All Other Plans	$101	309%
Multiplan Integrated Hp	$101	309%
Cigna	$104	318%
Multiplan Pponext	$108	330%
Osf Direct Access Network-All Plans	$108	330%
Multiplan-All Other Plans	$115	351%
Humana	$120	367%
Corvel-All Plans	$122	373%
Healthsmart Adult-All Other Plans	$122	373%
Healthsmart Pediatric	$122	373%
Hfn-All Plans	$122	373%
Multiplan Beech Street	$122	373%
Multiplan Phcs Adult	$122	373%
Multiplan Phcs Pediatric	$122	373%
Usa Mco-All Plans	$122	373%

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 $122.
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 Hammond Henry Hospital 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.