Physical therapy (neuromuscular re-education)
Facility: F W Huston Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $79
- Cash Discount Price: $82
- 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% |
| Aetna | $76 | 232% |
| Humana | $81 | 247% |
| Cigna | $87 | 266% |
Consumer Guidance & Cost Commentary
For the Physical therapy (neuromuscular re-education) service at F W Huston Medical Center in Winchester, KS, the facility's cash median rate of $82.00 is notably lower than the state average of $102.00, offering a potential savings of $20.00 for patients paying out-of-pocket. While the facility's negotiated rates with major payers like Blue Cross Blue Shield ($50), Aetna ($76), Humana ($81), and Cigna ($87) are generally close to or slightly above the cash price, the cash option remains the most affordable direct payment method available. It is important to note that for patients with high-deductible plans, paying the cash price of $82.00 upfront can be more cost-effective than relying on insurance, especially since the negotiated rates for some carriers exceed the cash rate. Patients should explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees.
When reviewing your final invoice, ensure you receive a detailed itemized bill rather than a summary statement, as over 80% of hospital bills contain errors such as double-billing or unbundled codes that can be corrected. If you receive a balance bill for the difference between the provider's full chargemaster rate and your insurance allowed amount, you may be protected under the No Surprises Act, which bans balance billing for emergency and non-emergency services at in-network facilities. To verify the true cost of care, compare the facility's Medicare amount of $32.73 against your commercial rates; while commercial