Physical therapy (neuromuscular re-education)
Facility: Community Memorial Healthcare, Inc.
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $43
- Cash Discount Price: $62
- vs. Medicare Baseline: 1.31x 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 |
|---|---|---|
| Aetna | $29 - $50 | 89% |
| UnitedHealthcare | $35 | 107% |
| Blue Cross Blue Shield | $50 | 153% |
Consumer Guidance & Cost Commentary
For Physical therapy (neuromuscular re-education) at Community Memorial Healthcare, Inc. in Marysville, KS, the cash price is $62.00, which matches the facility's median negotiated rate. While this cash price is higher than the Medicare benchmark of $32.73, it is significantly lower than the typical commercial negotiated rates found in the region, which often average between 200% and 300% of the Medicare rate. Because commercial insurance contracts frequently include administrative overheads that inflate the baseline price by 20% to 40%, paying cash directly can sometimes result in a lower out-of-pocket cost than using an in-network plan where the deductible has not yet been met. Patients should verify their specific plan's allowed amount before scheduling, as some insurers may negotiate rates that exceed the facility's cash price.
To ensure you are receiving the most accurate pricing, we recommend requesting a prompt-pay discount from the hospital, which can reduce the bill by 20% to 50% if paid in full upfront. This discount bypasses the costly insurance claims processing cycle, saving the facility administrative labor and providing immediate liquidity. Additionally, if you have an out-of-network plan, be aware that balance billing could occur where the provider bills you for the difference between their full chargemaster rate and the insurer's allowed amount; however, the No Surprises Act protects you from such surprise bills for emergency care and non-emergency services at in-network facilities. Always request a detailed, itemized bill before paying to identify any errors, double-billing, or services not rendered, as over 80% of hospital bills contain mistakes that can be corrected through a formal written dispute