Physical therapy (neuromuscular re-education)
Facility: Kansas Surgery & Recovery Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $37
- Cash Discount Price: $82
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| Blue Cross Blue Shield | $30 - $37 | 92% |
| Aetna | $30 - $51 | 92% |
| UnitedHealthcare | $30 - $82 | 92% |
| Cigna | $82 | 251% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy at Kansas Surgery & Recovery Center in Wichita, KS, the cash price is $82.00. This cash rate aligns exactly with the facility's median negotiated rate of $37.00 and the cash median reported in the data, suggesting that paying out-of-pocket may be more cost-effective than using insurance for this specific service. While the facility is an Acute Care Hospital in a Voluntary non-profit private ownership structure, patients should verify their specific plan details, as commercial negotiated rates for this procedure vary significantly among payers, ranging from $30 to $82 depending on the insurance carrier.
The facility's pricing is notably higher than the Medicare benchmark, which is set at $32.73 for this code. The reported vs_medicare ratio of 1.1 indicates the cash price is 110% of the Medicare amount, a figure that falls within the range often considered fair pricing (typically 120% to 150% of Medicare) rather than the higher markups sometimes seen in commercial contracts. Given that over 80% of hospital bills contain errors, patients are strongly advised to request an itemized billing audit before finalizing payment to ensure no unbundled codes or services not rendered are included. Additionally, since the facility offers prompt-pay discounts to improve cash flow, patients should inquire about self-pay or prompt-pay reductions prior to scheduling to potentially lower the final amount owed.