Physical therapy (neuromuscular re-education)
Facility: Rawlins County Health Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $91
- Cash Discount Price: $94
- vs. Medicare Baseline: 2.78x 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 278% of the Medicare baseline (a markup of 178%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 | 153% |
| UnitedHealthcare | $91 - $100 | 278% |
Consumer Guidance & Cost Commentary
For this Physical therapy (neuromuscular re-education) service at Rawlins County Health Center in Atwood, KS, the cash price is $94.00, which is lower than the facility's negotiated rates of $91.00 and the state average of $110.00. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that insurance plans like Blue Cross Blue Shield and UnitedHealthcare have negotiated rates that often exceed cash prices due to administrative costs and claim processing fees. If you have a high-deductible plan, paying the cash price of $94.00 upfront may result in immediate savings compared to your insurance paying a higher negotiated amount, provided you have not yet met your deductible.
To ensure you are not overcharged, it is recommended to request a full itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, you should verify if the facility offers a prompt-pay discount for self-pay patients, which could further reduce the $94.00 cash price. If you receive a balance bill from an out-of-network provider, remember that the No Surprises Act protects you from paying the difference between the provider's full chargemaster rate and your insurance allowed amount for emergency care and non-emergency services at in-network facilities. Always check with the hospital directly for self-pay or prompt-pay options before scheduling your visit to avoid unexpected costs.