Physical therapy (neuromuscular re-education)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $72
- Cash Discount Price: $53
- vs. Medicare Baseline: 2.20x 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 220% of the Medicare baseline (a markup of 120%). 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 |
|---|---|---|
| Lucent Health [6000] | $72 | 220% |
| Healthcare Highways [2210] | $72 | 220% |
| Aetna | $72 | 220% |
| Web Tpa [2115] | $72 | 220% |
| Oncology Patient Assistance Programs [2295] | $72 | 220% |
| Hooray Health [8000] | $72 | 220% |
| Blue Cross Blue Shield | $72 | 220% |
| Black Lung [6055] | $72 | 220% |
| Department Of Corrections [1340] | $88 | 269% |
| Healthpartners [1500] | $101 | 309% |
| American Postal Workers Union [1070] | $101 | 309% |
| Cigna | $101 | 309% |
| National Association Of Letter Carriers [1695] | $101 | 309% |
| Humana | $103 | 315% |
| Multiplan [1680] | $136 | 416% |
| American Healthcare [1055] | $136 | 416% |
| First Health [1375] | $136 | 416% |
| Administrative Concepts [1005] | $136 | 416% |
| Coventry Healthcare [1320] | $144 | 440% |
| Ks Disability Determination [6090] | $175 | 535% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy for neuromuscular re-education, the University of Kansas Health System - St Francis Campus in Topeka, KS, lists a cash median payment of $53.00 and a negotiated median of $72.00. This negotiated rate aligns with the lowest end of the range observed across 20 payers, with many plans paying exactly $72.00. While the facility's cash price is notably lower than the negotiated amounts, patients should be aware that commercial rates often include administrative overhead and contract structures that can make them higher than the cash price. If a patient has a high-deductible plan, paying the cash price of $53.00 upfront may result in lower out-of-pocket costs compared to the $72.00 negotiated rate, provided the insurance does not cover the service or the patient has not yet met their deductible.
The facility's pricing is also evaluated against federal benchmarks, showing a ratio of 2.2 times the Medicare amount of $32.73. This indicates that the commercial negotiated rates are significantly higher than the federal baseline, which is calculated based on actual provider costs plus a small margin. To ensure you are receiving the most accurate pricing, it is recommended to request an itemized billing audit before finalizing payment, as summary bills can obscure individual line items and potential errors. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed by bypassing the standard insurance billing cycle.