CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Kosciusko Community Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $65
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 1.99x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Kosciusko Community Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.99x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$65

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: $32 (98%)
Insurance Median: $65 (199%)
Cash: $32 (98% of Medicare)
Ins. Median: $65 (199% 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
Amish Aid $16 - $45 49%
Self Pay $16 - $84 49%
Lutheran Preferred Network $25 - $173 76%
Theramatrix $25 76%
UnitedHealthcare $28 - $186 86%
Physicians Health Plan $29 - $100 89%
Tricare $29 89%
Php Freedom Network $30 - $83 92%
Aetna $31 - $115 95%
Blue Cross Blue Shield $31 - $186 95%
Department Of Veterans Affairs $31 95%
Encore $31 - $86 95%
Humana $31 - $186 95%
Iu Health $31 95%
Medicare (plans) $31 95%
Mhs $31 - $186 95%
Node Non Par Hospice Agree $31 95%
Node Va $31 95%
One Call Care Diagnostics Wc $31 95%
Trma Inc $31 - $97 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%
Connecticut General Life Insurance Company $46 - $127 141%
Lutheran Advanced Network $47 144%
Lutheran Preferred $47 - $63 144%
Cigna $49 - $137 150%
Align In Work Comp $50 153%
One Call Work Comp $50 153%
Us Department Of Labor $50 153%
Encore Work Comp In $57 174%
Prime Health Services $57 - $162 174%
First Health Network $58 - $162 177%
Managed Health Services Exchange $63 192%
Workers Comp $63 192%
Advantage Health $65 - $179 199%
Private Healthcare Systems $67 - $186 205%
Sagamore $69 - $203 211%
Encore Health Network $73 - $201 223%
Encore Kba Epo $75 229%
Encore Kba Ppo $94 287%
Caresource $143 - $186 437%
Managed Health Services $186 568%
Medicaid / KanCare $186 568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals