Physical therapy (neuromuscular re-education)
Facility: Southwest Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $69
- Cash Discount Price: $63
- vs. Medicare Baseline: 2.11x 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 211% of the Medicare baseline (a markup of 111%). 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 |
|---|---|---|
| Health_Choice | $38 - $253 | 116% |
| Wppa | $38 - $253 | 116% |
| Aetna | $44 - $290 | 134% |
| Multiplan_Phcs_Primary_Network | $46 - $308 | 141% |
| United_Healthcare_Commercial | $47 - $315 | 144% |
| National_Beef_Packing | $49 - $326 | 150% |
| Multiplan_Phcs_Auto | $49 - $326 | 150% |
| Omni_Network | $49 - $326 | 150% |
| Multiplan_Phcs_Complementary_Network | $51 - $337 | 156% |
Consumer Guidance & Cost Commentary
For CPT code 97112, Physical therapy (neuromuscular re-education), at Southwest Medical Center in Liberal, KS, the cash median price is $63.00. This cash rate is notably lower than the facility's negotiated rates, which range from $49 to $337 across nine commercial payers, reflecting the administrative overhead and contract structures that often inflate insurance billing. While the facility is an Acute Care Hospital with a government-local ownership structure, patients should be aware that commercial negotiated rates frequently exceed cash prices; in cases where a patient has a high deductible or limited insurance coverage, paying the cash median of $63.00 upfront can result in significant savings compared to the allowed amounts charged by insurers.
To maximize cost savings, patients should verify if the facility offers self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can bypass the costly claims processing cycle that inflates insurance rates. It is important to note that while the facility's pricing is benchmarked against Medicare, which sets a baseline of $32.73 for this service, commercial rates often mark up significantly above this federal standard. Consumers are advised to request an itemized bill to ensure no errors exist and to explicitly ask for a waiver of insurance submission if they choose to pay out-of-network cash, thereby avoiding potential balance billing issues and securing the most favorable rate available.