Physical therapy (neuromuscular re-education)
Facility: Kingman Healthcare Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $136
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 4.16x 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 416% of the Medicare baseline (a markup of 316%). 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 |
|---|---|---|
| Humana | $136 | 416% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing physical therapy for neuromuscular re-education, the negotiated rate at Kingman Healthcare Center in Kingman, KS, is $136.00. This facility, a voluntary non-profit Critical Access Hospital, has a single payer contract with Humana, which pays exactly $136.00. While the facility does not currently list a cash or self-pay price, patients should be aware that cash payments can sometimes be cheaper than insurance negotiated rates, particularly for those with high-deductible plans where the insurer's allowed amount exceeds the cash price. It is strongly recommended to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can range from 20% to 50% off the billed amount when paid in full upfront, bypassing the administrative costs associated with insurance claims processing.
When evaluating the cost of this service, it is important to compare rates against the Medicare benchmark rather than the facility's full chargemaster list, as commercial rates often include significant administrative markups. Although specific state or county average data for this code is not provided in the current dataset, the Medicare amount for this procedure is $32.73. Under standard pricing benchmarks, fair commercial rates typically fall between 120% and 150% of the Medicare rate, whereas many in-network rates can reach 200% to 300%. If a patient receives a bill that exceeds these benchmarks, they should request an itemized billing audit to identify potential errors, such as unbundled codes or services not rendered, and dispute any balance billing that may arise from out-of-network anc