Physical therapy (neuromuscular re-education)
Facility: Kansas Medical Center Llc
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $31
- Cash Discount Price: $42
- 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 |
|---|---|---|
| Tricare | $27 | 82% |
| Medicaid / KanCare | $27 | 82% |
| Indian Health | $28 | 86% |
| Wppa | $28 | 86% |
| Ambetter / Centene | $31 | 95% |
| Medadv_Wellcare | $31 | 95% |
| Humana | $31 | 95% |
| Blue Cross Blue Shield | $31 - $48 | 95% |
| Three_Rivers | $62 | 189% |
| Aetna | $64 | 196% |
| United | $71 | 217% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy (neuromuscular re-education), the gross charge at Kansas Medical Center Llc in Andover, KS, is $71.00. This facility's cash median rate of $42.00 is significantly lower than the median negotiated rate of $71.00, which aligns exactly with the gross charge. While the facility's negotiated rates range from $27 to $64 across various payers, the cash price offers a substantial discount for patients without insurance or those with high-deductible plans. It is important to note that commercial insurance rates often include administrative overhead and claim processing costs, making the upfront cash price a more efficient option for many consumers. Patients should verify their specific plan's allowed amount, as some negotiated rates may still exceed the cash price depending on the payer's contract terms.
This facility is an Acute Care Hospital in Kansas, and its pricing structure is evaluated against federal benchmarks. The Medicare amount for this service is $32.73, which serves as the objective baseline for cost comparison. The facility's cash rate of $42.00 is approximately 128% of the Medicare amount, falling within the range often considered fair pricing, whereas commercial negotiated rates can sometimes reach 200% to 300% of the Medicare baseline. To maximize savings, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, if a patient receives care from an out-of-network provider at this facility, they should be