Physical therapy (neuromuscular re-education)
Facility: Wesley Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $41
- Cash Discount Price: $517
- vs. Medicare Baseline: 1.25x 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 |
|---|---|---|
| Humana | $27 - $31 | 82% |
| Coventry Health Care | $27 - $31 | 82% |
| UnitedHealthcare | $27 | 82% |
| Devoted Health | $27 - $31 | 82% |
| Aetna | $27 - $200 | 82% |
| United | $28 - $233 | 86% |
| Amerigroup | $28 | 86% |
| Medicaid / KanCare | $28 | 86% |
| Ambetter / Centene | $29 - $93 | 89% |
| Triwest Health Alliance | $30 | 92% |
| Correct Care Solutions | $41 - $47 | 125% |
| Blue Cross Blue Shield | $42 | 128% |
| First Health | $45 - $238 | 137% |
| Multiplan | $46 - $465 | 141% |
| Health Partners Of Kansas | $89 - $258 | 272% |
| Wppa | $90 | 275% |
| Medical Associates Health Plan | $98 | 299% |
| Preferred Health Choices | $98 | 299% |
| Spirit Aerosystems | $165 | 504% |
| Triwest Healthcare Alliance | $336 | 1027% |
| Usa Managed Care | $439 | 1341% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy for neuromuscular re-education, the cash price at Wesley Medical Center in Wichita, KS, is $517.00. This cash rate is significantly higher than the state average, which is 1.3 times the Medicare benchmark of $32.73. While commercial insurance plans like Multiplan and First Health have negotiated rates reaching up to $465 and $238 respectively, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans should consider that paying the cash price directly might be more cost-effective than relying on insurance, as the negotiated rates for many payers do not reflect the true cost of care and can result in higher out-of-pocket expenses if the patient's deductible has not yet been met.
To minimize costs, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront. It is important to verify the specific allowed amount for your insurance plan before scheduling, as in-network rates vary widely among carriers and do not guarantee the lowest possible price. Additionally, if you receive an itemized bill, request a full line-by-line audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. By comparing the facility's rates directly to the Medicare benchmark rather than the inflated chargemaster list, you can better understand the markup and negotiate a fair settlement.