Physical therapy (neuromuscular re-education)
Facility: Overland Park Reg Med Ctr
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $46
- Cash Discount Price: $329
- vs. Medicare Baseline: 1.41x 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 |
|---|---|---|
| United | $27 - $148 | 82% |
| Humana | $27 - $70 | 82% |
| Coventry | $27 - $132 | 82% |
| Blue Cross Blue Shield | $27 - $142 | 82% |
| Amerigroup | $27 | 82% |
| Devoted Health | $27 - $31 | 82% |
| Aetna | $28 - $168 | 86% |
| Celtic | $28 - $32 | 86% |
| Healthyblue | $28 | 86% |
| Medicaid / KanCare | $28 | 86% |
| Unicare | $28 | 86% |
| Wellcare | $28 - $32 | 86% |
| Cigna | $28 - $32 | 86% |
| Pyramid Life | $29 - $33 | 89% |
| Triwest Health Alliance | $30 | 92% |
| Home State Health Plan | $30 | 92% |
| Multiplan | $38 - $244 | 116% |
| Corvel Corporation | $45 - $214 | 137% |
| Oha Network | $46 - $165 | 141% |
| Ambetter / Centene | $61 | 186% |
| Nhc Advantage | $63 | 192% |
| Oscar | $63 | 192% |
| Wppa Providrs Care Network | $66 | 202% |
| Universal Healthcare | $115 | 351% |
| Coventry Kc Mo | $135 | 412% |
| College Park Family Care Center | $142 | 434% |
| Cco, Inc. | $247 | 755% |
| Focus Healthcare Mgmt, Inc | $247 | 755% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy at Overland Park Reg Med Ctr, the cash median price is $329.00. This cash rate is significantly lower than the facility's gross charge of $329.00 and aligns with the cash median reported for this service. When compared to the Medicare benchmark of $32.73, the cash price represents a 1.4x markup, which falls within the typical range where commercial rates can exceed 200% of Medicare. However, patients should be aware that many commercial payers listed, such as United, Humana, and Coventry, have negotiated rates ranging from $27 to $148, which are often lower than the cash price. In cases where a patient's insurance allows a high negotiated rate or if they have not yet met their deductible, paying the cash price upfront could result in substantial savings, provided they secure a prompt-pay discount before the claim is submitted.
The facility offers 28 different payer plans, with negotiated rates varying widely; for instance, United plans range from $27 to $148, while Multiplan plans can reach up to $244. The median negotiated rate across all payers is $46.00, which is substantially lower than the cash price, suggesting that for most insured patients, the insurance payment will cover the service cost. However, patients must actively request a "self-pay" or "prompt-pay" discount prior to scheduling to avoid automatic claims submission, which could void any potential cash savings. It is also important to note that the facility is an Acute Care Hospital