Physical therapy (neuromuscular re-education)
Facility: Meade District Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $66
- Cash Discount Price: $99
- vs. Medicare Baseline: 2.02x 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 202% of the Medicare baseline (a markup of 102%). 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 | $66 | 202% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy at Meade District Hospital, the cash price is $99.00. This cash rate is notably higher than the negotiated rate of $66.00, which is the amount Blue Cross Blue Shield pays for this service. While the facility is a Critical Access Hospital in Meade, Kansas, the data does not provide specific state or county average comparisons for this procedure. However, it is important to note that for patients with high-deductible plans, paying the cash price of $99.00 upfront can sometimes be more cost-effective than using insurance, as the negotiated rate of $66.00 is often subject to deductibles and co-pays that may exceed the cash amount. Additionally, patients should inquire about "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full within a short window, bypassing the administrative costs associated with insurance claims.
The Medicare benchmark for this service is $32.73, which serves as a baseline to evaluate the facility's pricing structure. The cash price of $99.00 is approximately three times the Medicare amount, reflecting the standard markup found in commercial billing. While the facility is government-owned, the data indicates no specific median paid amount was recorded for this code. To avoid unexpected costs, patients should request an itemized bill before payment to ensure no services were unbundled or double-charged, as over 80% of hospital bills contain errors. If a balance bill arises from out-of-network ancillary services, patients have the right to dispute the charge under