Physical therapy (neuromuscular re-education)
Facility: Girard Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $43
- Cash Discount Price: $74
- 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 |
|---|---|---|
| Kansas Superior Select-All Plans | $43 | 131% |
| Blue Cross Blue Shield | $43 - $50 | 131% |
| Aetna | $43 - $215 | 131% |
| Ambetter / Centene | $43 | 131% |
| UnitedHealthcare | $43 - $117 | 131% |
| Medicare (plans) | $43 | 131% |
| Humana | $43 | 131% |
| Multiplan-All Plans | $114 | 348% |
| Uhhis-All Plans | $117 | 357% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, Physical therapy (neuromuscular re-education), at Girard Medical Center in Girard, KS, the facility's cash median rate is $74.00, while the median negotiated rate across nine payers is $43.00. This negotiated rate aligns with the state average of $43.00, indicating that in-network members are paying the standard benchmark for this service in Kansas. However, patients should note that cash payments can sometimes be more cost-effective for those with high-deductible plans if their insurance negotiated rate exceeds the cash price. Since the cash rate here is higher than the negotiated rate, paying out-of-pocket directly would result in a higher out-of-pocket cost compared to using an in-network plan.
To ensure you are receiving the most accurate pricing, it is important to request an itemized billing audit before finalizing payment, as summary bills often obscure individual code costs and may include unbundled charges or services not rendered. Additionally, while the facility is a Critical Access Hospital with a government ownership structure, patients should explicitly ask about self-pay or prompt-pay discounts prior to scheduling, as these upfront incentives can reduce the total bill by 20% to 50%. If you encounter a balance bill or unexpected charges, you have the right to dispute the amount and request a full line-by-line review to identify any errors or unbundled codes that should not be included in your final invoice.