CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: The Orthopaedic Hospital of Lutheran Health Networ

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $50
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at The Orthopaedic Hospital of Lutheran Health Networ is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $50. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 7952 W Jefferson Blvd, Ft Wayne, IN.
Cash / Self-Pay
$50

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $50 (153%)
Insurance Median: $63 (192%)
Cash: $50 (153% of Medicare)
Ins. Median: $63 (192% 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 $19 - $119 58%
Amish Aid $21 - $83 64%
Self Pay $21 - $83 64%
Lutheran Preferred $23 - $184 70%
Php Freedom Network $24 - $63 73%
Theramatrix $25 76%
Cigna $27 - $306 82%
UnitedHealthcare $28 - $186 86%
Tricare $29 89%
Aetna $30 - $148 92%
Blue Cross Blue Shield $31 - $186 95%
Department Of Veterans Affairs $31 95%
Humana $31 - $186 95%
Iu Health Plan $31 95%
Medicare (plans) $31 95%
Node Hospice Non Par Agree $31 95%
Node Mhs Mcr Adv $31 95%
Node Va $31 95%
Small Business Aid $31 95%
Three Rivers Preferred $31 - $138 95%
Node Devoted Health Mcr Adv $32 98%
Police And Sheriff $32 98%
In Dept Of Correction $33 101%
Node Pphp Mcr Adv $33 101%
One Call Work Comp $33 101%
Sagamore $38 - $147 116%
Encore Ppo $39 - $153 119%
Lutheran Advanced Network $47 144%
Node Lutheran Three Rivers Preferred Plus 150 $47 144%
Occunet In Work Comp $47 - $80 144%
Align Network $50 153%
Node Us Dept Of Labor $50 153%
Multiplan $54 - $239 165%
Node Lutheran Three Rivers Preferred Plus 175 $55 168%
Encore Wc $57 174%
Medrisk In Work Comp $57 174%
Prime Health Services $57 - $230 174%
Three Rivers Preferred In Work Comp $57 174%
First Health $60 - $236 183%
Objective Surgical $61 186%
Encore $62 - $245 189%
In Work Comp $63 192%
Lutheran Network $63 192%
Managed Health Services $63 - $186 192%
Encore Kba Epo $75 229%
Encore Kba Ppo $94 287%
Objective Surgery Work Comp $110 336%
Medicaid / KanCare $143 - $186 437%
Caresource $186 568%
Mhs $186 568%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7952 W Jefferson Blvd, Ft Wayne, IN 46804
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals