CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Decatur County Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $168
Cash Discount Price: $237
vs. Medicare Baseline: 5.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Decatur County Memorial Hospital is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $237. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.13x the Medicare baseline. Located in 720 North Lincoln Street, Greensburg, IN.

Cash / Self-Pay

$237

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $237 (724%)

Insurance Median: $168 (513%)

Cash: $237 (724% of Medicare)

Ins. Median: $168 (513% 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 513% of the Medicare baseline (a markup of 413%). 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
Blue Cross Blue Shield	$43 - $629	131%
Choice Care Mcr Adv	$43 - $182	131%
Siho Mcr Adv	$43 - $182	131%
UnitedHealthcare	$43 - $182	131%
Caresource Mcr Adv	$45 - $192	137%
Aetna	$51 - $478	156%
Caresource Just4Me-All Other Plans	$73 - $310	223%
Cigna	$115 - $484	351%
Sagamore Health-All Plans	$119 - $503	364%
Encircle-All Plans	$127 - $535	388%
Healthsource Indiana-All Plans	$134 - $566	409%
Choicecare Commercial-All Other Plans	$139 - $585	425%
Thcg/Encore-All Plans	$140 - $591	428%
Siho-All Other Plans	$145 - $610	443%
Medicaid / KanCare	$149 - $629	455%

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 $237.
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 Decatur County Memorial Hospital 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.