Physical therapy (neuromuscular re-education)
Facility: Goodland Regional Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $77
- Cash Discount Price: $77
- vs. Medicare Baseline: 2.35x 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 235% of the Medicare baseline (a markup of 135%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $50 | 153% |
| Wppa | $72 - $76 | 220% |
| UnitedHealthcare | $76 | 232% |
Consumer Guidance & Cost Commentary
For Physical therapy (neuromuscular re-education) at Goodland Regional Medical Center, the cash median price is $77.00, which is lower than the facility's negotiated rates of $77.00 to $76.00 depending on the payer. While the facility is a Critical Access Hospital in Goodland, KS, the data does not provide specific county or state average benchmarks for this procedure, so a direct comparison to regional pricing is not available. However, patients with high-deductible plans may find the cash price advantageous if their insurance negotiated rates exceed this amount, as paying out-of-pocket can sometimes result in lower total costs than the insurance allowed amount. It is important to verify your specific plan's negotiated rate before scheduling, as in-network contracts vary significantly even within the same facility.
The Medicare benchmark for this service is $32.73, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $77.00 represents a significant markup over the Medicare amount, reflecting the costs of physician work, practice expenses, and malpractice insurance included in the billing structure. Commercial negotiated rates for payers like Blue Cross Blue Shield, Wppa, and UnitedHealthcare range from $50.00 to $76.00, with the lowest rate being $50.00. To maximize savings, patients should ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, requesting a detailed, itemized bill is essential to identify any errors, unbundled codes, or services not rendered