Physical therapy (neuromuscular re-education)
Facility: Republic County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $79
- Cash Discount Price: $65
- vs. Medicare Baseline: 2.41x 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 241% of the Medicare baseline (a markup of 141%). 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 |
|---|---|---|
| Rural Carriers-All Plans | $73 | 223% |
| Meritain-All Plans | $77 | 235% |
| Aetna | $77 | 235% |
| UnitedHealthcare | $79 | 241% |
| First Health-All Plans | $82 | 251% |
| Midlands Choice-All Plans | $82 | 251% |
| Cigna | $82 | 251% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy neuromuscular re-education, Republic County Hospital in Belleville, KS, lists a cash median price of $65.00. This cash rate is notably lower than the facility's negotiated rates, which average $79.00 across seven payers including Rural Carriers, Aetna, and UnitedHealthcare. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should be aware that paying cash upfront may offer the best value if their insurance deductible has not yet been met, as the negotiated rate often exceeds the cash price. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront incentives can bypass the administrative costs associated with insurance claims processing.
When reviewing the billing statement for this service, consumers should request a full itemized bill rather than accepting a summary invoice that obscures individual charges. Since over 80% of hospital bills contain errors such as unbundled codes or services not rendered, a line-by-line audit is the most effective way to identify and correct mistakes before payment. Additionally, this service's Medicare benchmark amount is $32.73, which serves as a scientifically validated baseline for evaluating the facility's pricing markup. By comparing the facility's negotiated rate of $79.00 against the Medicare amount, patients can see that the commercial rate is approximately 2.4 times the Medicare benchmark, highlighting the importance of understanding the true cost of care rather than relying solely on the hospital's gross charges.