Physical therapy (neuromuscular re-education)
Facility: Pratt Regional Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $89
- Cash Discount Price: $78
- vs. Medicare Baseline: 2.72x 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 272% of the Medicare baseline (a markup of 172%). 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 |
|---|---|---|
| Celtic Insurance Company | $32 | 98% |
| Healthy Blue | $33 | 101% |
| UnitedHealthcare | $35 - $137 | 107% |
| Christian Health Aid | $67 - $101 | 205% |
| Health Partners Of Kansas | $76 - $114 | 232% |
| Aetna | $80 - $121 | 244% |
| Choicecare | $89 - $134 | 272% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, Physical therapy (neuromuscular re-education), Pratt Regional Medical Center in Pratt, KS, lists a gross charge of $112.00. This amount is significantly higher than the Medicare benchmark of $32.73, which serves as the federal baseline for this service. While the facility's cash median price is $78.00, commercial insurance negotiated rates vary widely, ranging from $32 to $134 depending on the payer. For instance, Celtic Insurance Company and Healthy Blue have fixed negotiated rates of $32 and $33 respectively, which are lower than the cash price, whereas UnitedHealthcare rates range from $35 to $137. Patients should be aware that in-network insurance rates often include administrative overhead and can exceed cash prices; therefore, paying cash or using a prompt-pay discount may result in lower out-of-pocket costs if the patient has a high deductible or no coverage.
The facility is located in Pratt, KS (Zip 67124) and is an Acute Care Hospital with a Proprietary ownership structure. While the provided data does not include specific state or county average comparisons for this code, the facility's cash median of $78.00 is notably higher than the Medicare amount of $32.73. To minimize costs, patients should verify their specific plan's allowed amount before scheduling, as some insurers may allow amounts closer to the cash price than the full negotiated rate. Additionally, patients should explicitly ask the billing department about self-pay or prompt-pay discounts before check-in, as these upfront payment incentives can bypass the costly insurance claims process and reduce the final