Physical therapy (neuromuscular re-education)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $30
- Cash Discount Price: $43
- vs. Medicare Baseline: 0.92x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medica Contracted [320239] | $24 | 73% |
| Medicaid / KanCare | $27 - $30 | 82% |
| Blue Cross Blue Shield | $27 - $61 | 82% |
| UnitedHealthcare | $28 - $44 | 86% |
| Tricare | $29 | 89% |
| Aetna | $30 - $56 | 92% |
| Pace Of The Ozarks Contracted [320518] | $30 | 92% |
| Medicare (plans) | $30 | 92% |
| Home State Health Plan Contracted [320187] | $30 | 92% |
| Humana | $30 | 92% |
| Cross Timbers Hospice [20098] | $30 | 92% |
| Kindful Hospice [20434] | $30 | 92% |
| Elara Caring Aspire Hospice [20433] | $30 | 92% |
| Kindful Hospice Contracted [320434] | $30 | 92% |
| Dept Of Veteran Affairs Contracted [320106] | $30 | 92% |
| Halo Hcr Inc Hospice Contracted [320432] | $30 | 92% |
| Mercy Hospice Okc [20252] | $30 | 92% |
| Halo Hcr Inc Hospice [20432] | $30 | 92% |
| Ambetter / Centene | $30 | 92% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $31 | 95% |
| United Medical Resources Contracted [320454] | $44 | 134% |
| Cigna | $46 - $51 | 141% |
| Health Choice Contracted [320166] | $50 | 153% |
| Workers Comp [20426] | $53 | 162% |
| Mercy Benefit Admin Contracted [320251] | $53 | 162% |
| Reflect Health Contracted [320492] | $53 | 162% |
| Yuzu Health Contracted [320521] | $53 | 162% |
| Edison Health Solutions Contracted [320502] | $53 | 162% |
| Healthlink Contracted [320179] | $53 | 162% |
| Ebms Contracted [320493] | $53 | 162% |
| American Healthcare Alliance Contracted [320020] | $53 | 162% |
| Auxiant Contracted [320462] | $53 | 162% |
| Imagine 360 Contracted [320494] | $53 | 162% |
| Aither Health Contracted [320449] | $53 | 162% |
| First Health Contracted [320128] | $56 | 171% |
| Providrs Care Network Contracted [320484] | $58 | 177% |
Consumer Guidance & Cost Commentary
For the physical therapy service (CPT 97112) at Mercy Hospital Pittsburg, Inc., the cash median rate is $43.00, which is notably higher than the state of Kansas average of $30.00. While commercial insurance plans typically negotiate rates ranging from $24 to $58 depending on the carrier, patients with high-deductible plans may find the cash price more advantageous if their insurer's negotiated rate exceeds $43.00. It is important to note that many commercial payers, such as Medicaid/KanCare and several Blue Cross Blue Shield plans, have negotiated rates that fall below the cash price, suggesting that paying out-of-pocket might result in higher costs for those specific policies.
To ensure you are receiving the most favorable rate, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors that can be corrected. Additionally, patients should inquire about prompt-pay discounts, which can reduce the total bill by 20% to 50% if paid in full upfront, effectively bypassing the administrative overhead associated with insurance claims. While the facility's negotiated rates are generally aligned with the state median of $30.00, verifying your specific plan's allowed amount and checking for self-pay discounts prior to scheduling can help avoid unexpected balances or unnecessary administrative fees.