Physical therapy (neuromuscular re-education)
Facility: Centura St. Catherine-Dodge City
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $167
- Cash Discount Price: $140
- vs. Medicare Baseline: 5.10x 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 510% of the Medicare baseline (a markup of 410%). 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 |
|---|---|---|
| Medicare (plans) | $33 | 101% |
| Cigna | $33 | 101% |
| Blue Cross Blue Shield | $33 - $59 | 101% |
| Kaiser | $33 | 101% |
| Humana | $33 | 101% |
| Aetna | $33 - $391 | 101% |
| Kansas Health | $33 | 101% |
| Centura Employee Plan | $72 | 220% |
| UnitedHealthcare | $137 - $322 | 419% |
| Wpaa | $146 - $342 | 446% |
| Multiplan | $167 - $440 | 510% |
| Christian Health Aid | $167 - $391 | 510% |
| Health Partners Of Kansas | $188 - $440 | 574% |
Consumer Guidance & Cost Commentary
For the physical therapy service (CPT 97112) at Centura St. Catherine-Dodge City in Dodge City, Kansas, the facility's cash median price is $140.00, which is significantly lower than the state average of $167.00. While commercial insurance plans like Aetna and Multiplan have negotiated rates ranging from $33 to $440, these amounts often exceed the cash price due to administrative overhead and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $140.00 directly, as this bypasses the higher negotiated rates that insurance carriers typically charge. It is important to verify the specific allowed amount with your insurer before scheduling, as in-network rates vary widely among the 13 payers listed, with some plans like Blue Cross Blue Shield showing a range of $33 to $59.
To maximize savings, patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, which can reduce the final bill by 20% to 50% by avoiding costly insurance billing cycles. Additionally, since the facility is an acute care hospital in Kansas, the Medicare benchmark for this service is $32.73; commercial rates are often marked up significantly above this federal baseline. If you receive a bill after using insurance, request a full itemized audit to identify any errors, double-billing, or unbundled codes, as over 80% of hospital bills contain inaccuracies. Finally, be aware that the No Surprises Act protects you from balance billing for emergency or non-emergency services at in-network