Physical therapy (neuromuscular re-education)
Facility: Cheyenne County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $79
- Cash Discount Price: $83
- vs. Medicare Baseline: 2.41x 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 241% of the Medicare baseline (a markup of 141%). 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% |
| First Health - All Plans | $58 | 177% |
| Tricare | $60 | 183% |
| Aetna | $60 - $79 | 183% |
| Healthy Blue Mcr Adv | $60 | 183% |
| UnitedHealthcare | $60 - $230 | 183% |
| Choice Care - All Plans | $60 | 183% |
| Firstguard - All Plans | $66 | 202% |
| Wppa - All Plans | $75 | 229% |
| Cpm - All Plans | $79 | 241% |
| Preferred Hc - All Plans | $79 | 241% |
| Unicare - All Plans | $81 | 247% |
| Health Partners - All Plans | $81 | 247% |
| Midlands Choice - All Plans | $81 | 247% |
| Integrated Hp - All Plans | $81 | 247% |
| Ppo Next - All Plans | $81 | 247% |
| Healthy Blue Mcaid - All Other Plans | $83 | 254% |
| Childrens Mercy - All Plans | $83 | 254% |
| Healthwave Mcaid - All Plans | $83 | 254% |
| Providers Care-All Plans | $124 | 379% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy at Cheyenne County Hospital, the cash price is $83.00, which matches the facility's gross charge. This cash rate is notably higher than the state of Kansas average, which sits at $75.00. While commercial insurance plans generally negotiate rates between $50.00 and $124.00 depending on the carrier, many plans fall within the $60.00 to $83.00 range. For patients with high-deductible plans who have not yet met their out-of-pocket threshold, paying the cash price of $83.00 upfront may be more cost-effective than relying on insurance, as the negotiated allowed amounts for some payers could exceed the cash rate.
To minimize potential costs, patients should explicitly request a prompt-pay discount before scheduling or checking in, as hospitals often offer significant reductions for upfront payment that are not automatically applied. It is also important to verify that the facility is in-network for your specific plan, as out-of-network services could theoretically trigger balance billing, though the No Surprises Act provides protections for emergency care and non-emergency services at in-network facilities. Finally, if you receive a bill, always demand a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered that can be disputed to reduce your final balance.