Physical therapy (neuromuscular re-education)
Facility: Ascension Via Christi Hospitals Wichita, Inc.
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $31
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.95x 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.
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 |
|---|---|---|
| Va | $30 | 92% |
| Saint Lukes Health Systems | $30 | 92% |
| Vc Hope | $30 | 92% |
| Via Christi Research | $30 | 92% |
| Medicare (plans) | $30 - $31 | 92% |
| Humana | $30 | 92% |
| UnitedHealthcare | $31 - $85 | 95% |
| Blue Cross Blue Shield | $31 | 95% |
| Corizon | $38 | 116% |
| Smarthealth | $43 | 131% |
| Medicaid / KanCare | $52 | 159% |
| Mdsave | $70 | 214% |
| Coventry City Of Wichita | $75 | 229% |
| Aetna | $106 | 324% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy neuromuscular re-education, the facility's negotiated rates range from $30 to $106 across 14 payers, with a median negotiated amount of $31.00. This commercial rate is significantly higher than the Medicare benchmark of $32.73, which serves as the federal baseline for cost. While commercial rates often average 200% to 300% of Medicare, this specific code shows a negotiated rate slightly below the Medicare amount for most plans, such as Va, Saint Lukes Health Systems, and Humana, where the rate is fixed at $30. However, for UnitedHealthcare, the rate can reach up to $85, illustrating how network tiering and contract dynamics can create substantial price variation even for the same service.
Patients should be aware that cash-pay options may offer a lower total cost than insurance claims, particularly if the insurance deductible has not yet been met or if the negotiated rate exceeds the cash price. Although the data does not list a specific cash median, facilities frequently offer prompt-pay discounts of 20% to 50% for upfront payment, which bypasses the administrative costs and claim processing fees that inflate insurance rates. It is advisable to contact Ascension Via Christi Hospitals Wichita, Inc. directly to inquire about self-pay or prompt-pay rates before scheduling, as these discounts are often not applied automatically once insurance information is entered into the billing system.