Physical therapy (neuromuscular re-education)
Facility: Hodgeman County Health Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $64
- Cash Discount Price: $73
- vs. Medicare Baseline: 1.96x 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 | $48 - $50 | 147% |
| UnitedHealthcare | $58 - $86 | 177% |
| Humana | $58 | 177% |
| Medicaid / KanCare | $58 - $91 | 177% |
| Triwest - All Plans | $58 | 177% |
| Aetna | $73 | 223% |
| First Health - All Plans | $82 | 251% |
| Health Partners - All Plans | $86 | 263% |
| Wppa (Provdrscare) - All Plans | $86 | 263% |
Consumer Guidance & Cost Commentary
For the Physical therapy (neuromuscular re-education) service at Hodgeman County Health Center in Jetmore, Kansas, the facility's cash median rate is $73.00, which matches the highest negotiated rate found among the nine insurance payers listed, including UnitedHealthcare and Medicaid/KanCare. While commercial insurance contracts often include administrative overhead that can inflate prices, the cash price here is notably lower than the facility's gross charge of $91.00. For patients with high-deductible plans, paying the cash rate of $73.00 upfront can be more cost-effective than relying on insurance, which may result in a higher allowed amount due to multi-layered contract structures and administrative costs. It is advisable to contact the hospital directly to confirm if additional self-pay or prompt-pay discounts are available before scheduling your visit.
When evaluating the cost of this service, it is important to compare the facility's rates against the Medicare benchmark rather than the inflated chargemaster list. The Medicare amount for this code is $32.73, and the facility's cash rate represents a markup of 2.0 times the Medicare rate, which falls within the range where commercial rates often average 200% to 300% of the federal baseline. Since the facility is a Critical Access Hospital with government-local ownership, the pricing reflects a specific cost basis rather than a standard commercial markup. To ensure you are receiving the most accurate pricing, always request an itemized bill that breaks down the specific CPT code and avoids summary totals that may obscure individual charges.