Physical therapy (neuromuscular re-education)
Facility: St. Catherine Hospital - Garden City
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $167
- Cash Discount Price: $120
- vs. Medicare Baseline: 5.10x 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 510% of the Medicare baseline (a markup of 410%). 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 |
|---|---|---|
| UnitedHealthcare | $32 - $303 | 98% |
| Aetna | $33 - $411 | 101% |
| Medicare (plans) | $33 | 101% |
| Devoted Health | $33 | 101% |
| Cigna | $33 - $202 | 101% |
| Kaiser | $33 - $83 | 101% |
| Kansas Health | $33 | 101% |
| Blue Cross Blue Shield | $33 - $205 | 101% |
| Humana | $33 | 101% |
| Innovage | $33 | 101% |
| Denver Health | $71 | 217% |
| Centura Employee Plan | $72 | 220% |
| Direct To Employer | $75 - $120 | 229% |
| Peak Health | $99 - $117 | 302% |
| Multiplan | $131 - $455 | 400% |
| United Colorado Doctor'S Plan | $143 - $150 | 437% |
| Wpaa | $146 - $342 | 446% |
| Christian Health Aid | $167 - $391 | 510% |
| Health Partners Of Kansas | $203 - $474 | 620% |
Consumer Guidance & Cost Commentary
For this physical therapy service at St. Catherine Hospital in Garden City, Kansas, the facility's cash median rate of $120.00 is significantly lower than the state average of $167.00 and the negotiated rate of $167.00. While Medicare sets a benchmark of $32.73, commercial payers negotiate rates that range widely, with UnitedHealthcare plans paying as high as $303 and Multiplan plans reaching up to $455. Patients with high-deductible plans may find it financially advantageous to pay the cash price of $120.00 upfront, as this amount is often lower than the insurance negotiated rate. To secure this lower cash price, it is essential to request a "self-pay" classification and prompt-pay discount before scheduling, and to sign a waiver preventing automatic claims submission to avoid being billed the higher insurance rate.
The facility's facility rating of 2 and ownership by a voluntary non-profit church organization are noted, but the primary financial consideration for consumers is the potential for balance billing if insurance coverage is not utilized correctly. Although the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, patients should still verify their specific plan details to ensure they are not subject to unexpected charges. If a patient receives an itemized bill, they should request a full line-by-line audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute.