Physical therapy (neuromuscular re-education)
Facility: Lincoln County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $51
- Cash Discount Price: $74
- vs. Medicare Baseline: 1.56x 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 | 153% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy neuromuscular re-education, Lincoln County Hospital lists a cash median price of $74.00, which is notably lower than the facility's gross charge of $83.00. While the facility is a Critical Access Hospital in Lincoln, KS, with government-local ownership, the data does not provide a specific county or state average for this procedure to compare against. However, the cash price is significantly lower than the Medicare benchmark of $32.73 multiplied by the 1.6x ratio, resulting in a Medicare-adjacent value of approximately $52.37. Patients with high-deductible plans may find this cash rate advantageous if their insurance negotiated rate exceeds $74.00, as paying out-of-pocket could result in immediate savings compared to the administrative costs and potential deductibles associated with using commercial insurance.
If you choose to use insurance, the median negotiated rate is $51.00, which is lower than the cash price but still subject to your plan's deductible and copayments. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates can vary significantly between carriers. To ensure you receive the best possible price, we recommend asking the hospital directly about "self-pay" or "prompt-pay" discounts, which can further reduce the cash median. Additionally, if you receive an itemized bill, review it carefully to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.