Physical therapy (neuromuscular re-education)
Facility: Logan County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $73
- Cash Discount Price: $20
- vs. Medicare Baseline: 2.23x 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 223% of the Medicare baseline (a markup of 123%). 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 |
|---|---|---|
| Humana | $42 | 128% |
| Blue Cross Blue Shield | $50 | 153% |
| Health Partners - All Plans | $95 | 290% |
| Medicaid / KanCare | $100 | 306% |
Consumer Guidance & Cost Commentary
For this Physical therapy (neuromuscular re-education) service at Logan County Hospital in Oakley, KS, the cash price is $20.00, which is significantly lower than the facility's negotiated rates of $73.00 and the median paid amount of $69.00. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash price. It is important to note that while the facility's negotiated rates are higher than the cash option, the data does not provide specific county or state average comparisons for this specific CPT code, so patients should verify local pricing trends directly with the hospital before scheduling.
Insurance coverage varies widely across payers, with Humana and Blue Cross Blue Shield negotiating a rate of $50.00, while Health Partners and Medicaid/KanCare set their rates at $95.00 and $100.00 respectively. Because these negotiated rates are substantially higher than the cash price, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before check-in to avoid unexpected balances. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should request a formal itemized audit to ensure accuracy, as over 80% of hospital bills contain errors. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network services at in-network facilities, meaning any surprise bills should be disputed with the insurer rather than paid immediately.