Physical therapy (neuromuscular re-education)
Facility: Osborne County Memorial Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $81
- Cash Discount Price: $76
- vs. Medicare Baseline: 2.47x 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 247% of the Medicare baseline (a markup of 147%). 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 |
|---|---|---|
| UnitedHealthcare | $67 - $68 | 205% |
| Health Partners Of Kansas | $76 - $77 | 232% |
| Wppa | $84 - $85 | 257% |
| Blue Cross Blue Shield | $86 - $87 | 263% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy, Osborne County Memorial Hospital lists a cash median price of $76.00, which is lower than the facility's gross charge of $89.00. While the facility is a Critical Access Hospital in Osborne, Kansas, with government-local ownership, the data does not provide specific county or state average benchmarks for this procedure to compare against. However, patients should note that commercial payers like UnitedHealthcare, Health Partners Of Kansas, Wppa, and Blue Cross Blue Shield have negotiated rates ranging from $67.00 to $87.00, which are generally higher than the cash price. This pricing structure highlights a common billing dynamic where cash-pay rates can be more affordable for patients with high-deductible plans or those without insurance, provided they qualify for self-pay or prompt-pay discounts before scheduling.
It is important to understand that commercial insurance rates often exceed cash prices due to the administrative costs and contractual structures involved in claims processing. Although the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients should verify their specific plan details and deductible status before relying on insurance coverage. To ensure they receive the most accurate pricing, consumers are encouraged to request an itemized billing audit if discrepancies arise, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Finally, patients should explicitly ask the hospital about prompt-pay discounts prior to check-in, as these upfront payment incentives can significantly reduce the final amount owed compared to standard billing cycles.