CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Franciscan Health Lafayette

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $162
Cash Discount Price: $57
vs. Medicare Baseline: 4.95x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Franciscan Health Lafayette is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $57. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.95x the Medicare baseline. Located in 1701 S Creasy Ln, Lafayette, IN.

Cash / Self-Pay

$57

Average discount available for prompt cash payment at this facility.

Insurance Median

$162

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: $57 (174%)

Insurance Median: $162 (495%)

Cash: $57 (174% of Medicare)

Ins. Median: $162 (495% 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 495% of the Medicare baseline (a markup of 395%). 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
Research/Grant [2012]	$5	15%
Medicare (plans)	$32	98%
Aetna	$61 - $187	186%
Blue Cross Blue Shield	$61 - $63	186%
Managed Care [2000]	$61 - $238	186%
Unicare [1150]	$61 - $63	186%
Workers Comp [1172]	$63	192%
UnitedHealthcare	$108 - $140	330%
Commercial [2001]	$120 - $264	367%
United Medical Resources [1158]	$120 - $128	367%
United Medical Resources [1301]	$120 - $140	367%
Humana	$168 - $178	513%
Cigna	$171 - $211	522%
Great West Insurance [1055]	$171 - $181	522%
Mdwise [1175]	$186	568%
Medicaid / KanCare	$186 - $224	568%
Managed Health Services [1302]	$192	587%

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 $57.
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 Franciscan Health Lafayette 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.