Physical therapy (neuromuscular re-education)
Facility: Jewell County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $99
- Cash Discount Price: $78
- vs. Medicare Baseline: 3.02x 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 302% of the Medicare baseline (a markup of 202%). 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 |
|---|---|---|
| Rural Carriers - All Plans | $88 | 269% |
| Aetna | $94 | 287% |
| Meritain - All Plans | $94 | 287% |
| Midlands Choice - All Plans | $99 | 302% |
| UnitedHealthcare | $99 | 302% |
| Cigna | $99 | 302% |
| First Health - All Plans | $99 | 302% |
Consumer Guidance & Cost Commentary
For the Physical therapy (neuromuscular re-education) service at Jewell County Hospital, the facility's cash median rate of $78.00 is notably lower than the state of Kansas average, which stands at $99.00. While the hospital's negotiated rates with major payers like Aetna, Cigna, and UnitedHealthcare are also $99.00, patients with high-deductible plans may find paying the cash price of $78.00 more cost-effective if their insurance allows exceeds this amount. Because commercial negotiated rates often include administrative overhead and do not reflect the true cost of care, comparing these figures to the Medicare benchmark of $32.73 reveals a significant markup; fair pricing for this service typically falls between 120% and 150% of the Medicare rate, whereas the current negotiated and cash rates exceed this range.
To minimize unexpected costs, patients should proactively request a "self-pay" or "prompt-pay" discount before scheduling, as these upfront payment incentives can bypass the costly insurance billing cycle and administrative fees. It is important to remember that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act, but patients should still verify their network status and avoid signing consent waivers that could waive these protections. Furthermore, since over 80% of hospital bills contain errors, patients should never accept a summary bill as final; instead, they should demand a full itemized statement to identify any unbundled codes or services not rendered, ensuring they only pay for the exact care received.