CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Lutheran Hospital of Indiana

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $52
  • Cash Discount Price: $30
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Lutheran Hospital of Indiana is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $30. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.59x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$30

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $30 (92%)
Insurance Median: $52 (159%)
Cash: $30 (92% of Medicare)
Ins. Median: $52 (159% 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
Physicians Health Plan Of Northern Indiana $19 - $124 58%
Ky Work Comp $20 - $79 61%
Amish Aid $23 - $94 70%
Lutheran Preferred Network $23 - $189 70%
Self Pay $23 - $113 70%
Cigna $25 - $114 76%
Theramatrix $25 76%
Php Freedom Network $26 - $67 79%
UnitedHealthcare $28 - $186 86%
Blue Cross Blue Shield $29 - $186 89%
Tricare $29 89%
Aetna $31 - $150 95%
Department Of Veterans Affairs $31 95%
Humana $31 - $186 95%
Iu Health Plan $31 95%
Lutheran Preferred $31 - $126 95%
Managed Health Services $31 - $186 95%
Medicare (plans) $31 95%
Node Hospice Non Par Agree $31 95%
Node Va $31 95%
One Call Care Diagnostics $31 95%
Veterans Eval Services $31 95%
Node Devoted Health Mcr Adv $32 98%
In Dept Of Correction $33 101%
Node Pphp Mcr Adv $33 101%
Sagamore $36 - $152 110%
Encore Ppo $38 - $154 116%
Lutheran Network $39 - $158 119%
Lutheran Advanced Network $47 144%
Node Lutheran Network $47 - $55 144%
Node Lutheran Preferred Fixed 2 $47 144%
Align Network $50 153%
Us Department Of Labor $50 153%
Encore Work Comp In $57 174%
Multiplan $57 - $261 174%
Prime Health Services $57 - $236 174%
Encore Health Network $64 - $284 196%
Advantage Health Solutions $65 - $261 199%
Allied Benefit Systems $70 - $284 214%
Evolutions $70 - $284 214%
Node Encore Kba Epo $75 229%
Node Encore Kba Ppo $94 287%
Care Source $186 568%
Medicaid / KanCare $186 568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals