CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University Of Kansas Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $85
  • Cash Discount Price: $39
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University Of Kansas Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.60x the Medicare baseline. Located in 4000 Cambridge Street, Kansas City, KS.
Cash / Self-Pay
$39

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)
Cash / Self-Pay: $39 (119%)
Insurance Median: $85 (260%)
Cash: $39 (119% of Medicare)
Ins. Median: $85 (260% of 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 260% of the Medicare baseline (a markup of 160%). 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Larned State Hospital [503200090] $28 - $87 86%
Medicare (plans) $30 - $31 92%
UnitedHealthcare $30 - $256 92%
Ku Athletics [503200094] $30 92%
Agency [50311255] $30 92%
Lasso Healthcare [503999926] $30 92%
Aetna $30 - $43 92%
Humana $30 - $31 92%
Devoted [503200068] $30 92%
Workers Comp [503999901] $30 - $280 92%
Blue Cross Blue Shield $31 - $226 95%
Allwell [503200078] $31 95%
American Health Plans [503200968] $32 98%
Oscar [503201609] $36 110%
Centurion [5032000966] $40 122%
Health Plan Inc [503999941] $44 - $139 134%
Alt Carelon Behavioral Health [503200905] $47 - $148 144%
Accarent Health [503999034] $47 - $148 144%
Ambetter / Centene $52 159%
Allied National [503999937] $56 - $177 171%
Php [503200005] $56 - $218 171%
Healthlink [503200007] $57 - $218 174%
Geha [503200036] $57 - $256 174%
Alt Wppa [5032000964] $57 - $179 174%
Cerner [503200038] $57 - $179 174%
Med-Pay [503200040] $57 - $179 174%
Inter-Americas Insurance [503999032] $57 - $179 174%
Wellfit [503301514] $58 177%
Centivo [5032000982] $58 177%
6 Degrees Health [503999050] $59 - $76 180%
Aha-Healthcare Preferred [503200050] $62 - $194 189%
First Health [5032000110] $62 - $194 189%
Correct Care Solutions [50311253] $66 - $206 202%
Coeur Plan Services [503301517] $66 - $206 202%
Consolidated Billing [50311256] $66 - $206 202%
Ascension Living Hope [503201517] $66 - $206 202%
Orscheln Industries [503201608] $70 - $221 214%
Alt Lineco [5032000976] $72 - $226 220%
Alt Lucent Health Solutions [503202603] $72 - $226 220%
Empire Plan/Nyship [503200705] $72 - $226 220%
Point Comfort Underwriters [503200018] $75 - $236 229%
Quiktrip [5032000412] $75 - $236 229%
Cigna $75 - $338 229%
Century Health Solutions [503200054] $75 - $236 229%
Wppa [503200056] $79 - $248 241%
Meritain Health [503200039] $79 - $248 241%
Claimdoc [503301509] $82 251%
Multiplan [503200057] $82 251%
Employers Health Network [503999025] $85 - $266 260%
Usa Managed Care [503999030] $85 - $266 260%
Plan Care America [503999026] $85 - $266 260%
Sanford Health Plan [503999027] $85 - $266 260%
Three Rivers Provider Network [503999029] $85 - $266 260%
Occunet [503999930] $90 275%
Fort Hays State Student Athletes [5032000960] $90 275%
Advanced Medical Pricing Solutions [503301513] $91 278%
Hchsync Centrus Health Direct [503999916] $130 - $150 397%
Medica [503200074] $216 - $256 660%
National Assn Letter Carriers [503200019] $338 1033%

Consumer Guidance & Cost Commentary

For this physical therapy service, the facility's cash price of $39.00 is significantly lower than the negotiated rates charged by most insurance plans, which range from $28 to $338 depending on the carrier. While the median negotiated rate across all payers is $85.00, the cash price remains the most affordable option for patients without insurance or those with high-deductible plans where the insurance allowed amount might exceed the cash rate. It is important to note that commercial rates often include administrative overhead and contract markups that do not apply to self-pay patients, making the direct cash price a reliable benchmark for the true cost of care.

Patients should verify their specific plan's allowed amount before scheduling, as some insurers may negotiate rates higher than the cash price, particularly for out-of-network scenarios where balance billing could occur. Although the No Surprises Act protects patients from balance billing for emergency services at in-network facilities, non-emergency procedures like this one may still result in unexpected charges if the provider is out-of-network. To minimize costs, individuals should contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the bill by bypassing the administrative fees associated with insurance claims processing.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4000 Cambridge Street, Kansas City, KS 66160
  • CMS Rating: ★★★★★
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals