Physical therapy (neuromuscular re-education)
Facility: Kiowa County Memorial Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $80
- Cash Discount Price: $77
- vs. Medicare Baseline: 2.44x 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 244% of the Medicare baseline (a markup of 144%). 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 - $80 | 153% |
| UnitedHealthcare | $72 - $90 | 220% |
| Health Partners Of Ks-All Plans | $79 | 241% |
| Humana | $80 | 244% |
| Medica Prime Mcare Cost-All Plans | $80 | 244% |
| Aetna | $80 | 244% |
| Celtic Comml Exchange-All Other Plans | $80 | 244% |
| Medicaid / KanCare | $90 | 275% |
| Providrs Care/Wppa-All Plans | $135 | 412% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy, Kiowa County Memorial Hospital in Greensburg, KS, lists a cash median price of $77.00 and a median negotiated rate of $80.00. While the cash price is slightly lower than the negotiated amount, patients should be aware that commercial insurance plans often pay significantly higher rates than cash; for instance, Medicaid/KanCare pays the full $90.00 gross, and some private plans like UnitedHealthcare and Blue Cross Blue Shield negotiate between $72.00 and $90.00. Because commercial negotiated rates frequently exceed cash prices, individuals with high-deductible plans may find paying the cash median of $77.00 directly to the hospital more cost-effective than relying on insurance, provided they have not yet met their deductible.
To ensure you are not overcharged, it is critical to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative costs associated with insurance claims. When comparing this facility's pricing to broader benchmarks, note that the Medicare amount for this service is $32.73; commercial rates are often marked up significantly above this baseline, so comparing your final out-of-pocket cost to the Medicare rate rather than the hospital's gross chargemaster provides a more accurate view of fair pricing.