Physical therapy (neuromuscular re-education)
Facility: University Of Kansas Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $85
- Cash Discount Price: $39
- vs. Medicare Baseline: 2.60x 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 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.
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.