Physical therapy (neuromuscular re-education)
Facility: Greenwood County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $53
- Cash Discount Price: $50
- vs. Medicare Baseline: 1.62x 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.
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 |
|---|---|---|
| Triwest - All Plans | $22 | 67% |
| UnitedHealthcare | $26 - $53 | 79% |
| Choicecare Mcr Adv - All Plans | $26 | 79% |
| Tricare | $26 | 79% |
| Integrated Health Plan - All Plans | $47 | 144% |
| Blue Cross Blue Shield | $48 - $50 | 147% |
| First Health - All Other Plans | $54 | 165% |
| First Health Ccn Network | $54 | 165% |
| Beech Street - All Plans | $54 | 165% |
| Preferred Hs (Coventry) - All Plans | $57 | 174% |
| Principal Health Care Inc - All Plans | $60 | 183% |
| Medicaid / KanCare | $63 | 192% |
| Amerigroup Mcaid-All Plans | $63 | 192% |
| Providrs Care/Wppa - All Plans | $94 | 287% |
Consumer Guidance & Cost Commentary
For CPT code 97112, Physical therapy (neuromuscular re-education), Greenwood County Hospital in Eureka, KS, lists a gross charge of $63.00. The facility's cash median rate is $50.00, which is lower than the state average of $53.00 and the median negotiated rate of $53.00. While the cash price is competitive, patients with high-deductible plans should consider that paying the $50.00 cash rate upfront may result in immediate savings compared to the higher allowed amounts charged by insurance carriers like UnitedHealthcare ($26–$53) or Blue Cross Blue Shield ($48–$50). It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront incentives can further reduce the final cost by bypassing administrative fees and claims processing delays.
The Medicare benchmark for this service is $32.73, which serves as a critical baseline for evaluating pricing fairness. Commercial negotiated rates often exceed Medicare benchmarks by 200% to 300%, though fair pricing is typically defined as 120% to 150% of the Medicare rate. In this case, the cash rate of $50.00 represents approximately 153% of the Medicare amount, aligning closely with the upper end of the fair pricing range. Patients should be aware of balance billing risks if they receive care from out-of-network providers, where the hospital could bill the difference between the full chargemaster and the insurance allowed amount. To avoid unexpected costs, consumers should request a detailed