Physical therapy (neuromuscular re-education)
Facility: Salina Regional Health Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $86
- Cash Discount Price: $75
- vs. Medicare Baseline: 2.63x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 263% of the Medicare baseline (a markup of 163%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Preferred Phsic | $39 - $82 | 119% |
| Preferred Healthcare - All Other Plans | $53 - $111 | 162% |
| Blue Cross Blue Shield | $53 - $56 | 162% |
| Multiplan (Mpi)-All Plans | $58 - $124 | 177% |
| Cigna | $58 - $124 | 177% |
| Providers Care (Wppa)-All Plans | $58 - $124 | 177% |
| Aetna | $58 - $124 | 177% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy, Salina Regional Health Center in Salina, KS, lists a gross charge of $107.00. While the facility offers a cash median price of $75.00, commercial insurance negotiated rates vary significantly across payers, ranging from a low of $39 to a high of $124. These negotiated amounts often exceed the cash price due to administrative overhead and contract structures, meaning patients with high-deductible plans might find paying the cash median of $75.00 more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the deductible has not been met.
When evaluating the facility's pricing against benchmarks, the Medicare amount for this service is $32.73, and the facility's cash rate is 2.6 times the Medicare amount. The median negotiated rate of $86.00 further illustrates the markup common in commercial contracts. To secure the best possible price, patients should verify their specific plan's allowed amount before scheduling and explicitly request "self-pay" or "prompt-pay" discounts from the billing department, as these upfront payment incentives can reduce the final bill by 20% to 50% by bypassing costly insurance claims processing.