CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ann & Robert H Lurie Childrens Hospital of Chicago

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $139
  • Cash Discount Price: $122
  • vs. Medicare Baseline: 4.25x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ann & Robert H Lurie Childrens Hospital of Chicago is $139. 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 4.25x the Medicare baseline. Located in 225 E Chicago Ave, Box 140, Chicago, IL.
Cash / Self-Pay
$122

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $139 (425%)
Cash: $122 (373% of Medicare)
Ins. Median: $139 (425% 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 425% of the Medicare baseline (a markup of 325%). 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
Medicare (plans) $30 - $2,656 92%
Mercycare Health $64 196%
Cigna $73 - $124 223%
Blue Cross Blue Shield $75 - $139 229%
Aetna $87 - $136 266%
Beacon Health Options $87 266%
La Rabida Childrens Hospital $87 266%
UnitedHealthcare $100 - $118 306%
Centegra $104 318%
Independent Physicians At Mercy $104 318%
Advanced Physicians Association Ipa $122 373%
Health Plus $122 373%
Imagine Health $122 373%
Methodist First Choice $122 373%
Northwest Community Healthcare $122 373%
Presence Health Partners $122 373%
St. Francis $122 373%
Ui Health $122 373%
West Suburban Health Providers $122 373%
Shriners Hospital $130 397%
Swedish Covenant Physician Partners $130 397%
American Psych Systems $139 425%
Health Alliance $139 425%
Macneal Health $139 425%
Magellan $139 - $900 425%
Healthlink Inc. $144 440%
Cofinity $148 452%
Hfn Inc $148 - $157 452%
Humana $148 452%
Principal Healthcare $148 452%
St. Elizabeth $148 452%
First Health $153 467%
Healthstar $153 467%
Preferred Health Network $153 467%
Sagamore Health Network $153 467%
Beech Street $157 480%
Benchmark Health $157 480%
Employer'S Coalition On Health $157 480%
Private Health Care System $157 480%
Security Health Plan $157 480%
Swedish American $157 480%
Wellmark/Healthnetwork $160 489%
Health Smart $165 504%
Integrated Health Plan $165 504%
Multiplan $165 504%
National Provider Network $165 504%
Wea Insurance Group $165 504%
Unicare $3,678 - $8,500 11237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 225 E Chicago Ave, Box 140, Chicago, IL 60611
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens