Physical therapy (neuromuscular re-education)
Facility: Kansas Spine & Specialty Hospital, Llc
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $31
- Cash Discount Price: $61
- 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 |
|---|---|---|
| Humana | $30 | 92% |
| Aetna | $31 - $39 | 95% |
| United Mine Workers Of America | $31 | 95% |
| Blue Cross Blue Shield | $31 | 95% |
| UnitedHealthcare | $31 - $38 | 95% |
| Providrs Care Network | $31 | 95% |
| Lantern Specialty Care | $50 | 153% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy neuromuscular re-education, Kansas Spine & Specialty Hospital, Llc in Wichita, KS, lists a cash median price of $61.00. This cash rate is notably lower than the facility's negotiated rates, which range from $30 to $50 depending on the specific insurance plan, with UnitedHealthcare plans reaching up to $38. While commercial negotiated rates often include administrative overhead and claims processing costs, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $61.00. To ensure the lowest possible cost, consumers should verify their specific plan's allowed amount and ask the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The facility's pricing is benchmarked against the Medicare rate of $32.73 for this service, showing a ratio of 0.9, which indicates the cash price is slightly below the federal baseline. It is important to note that comparing these rates to the hospital's gross charges is misleading, as chargemasters are inflated to make discounts appear larger; the true cost baseline is the Medicare rate. Additionally, patients should avoid accepting summary bills that only show broad categories like "Laboratory" or "Pharmacy," as these often obscure individual code costs and potential errors. For the most accurate pricing, request a full itemized CPT-coded bill before payment to identify any unbundled charges or services not rendered, ensuring you are paying only for the actual care received.