Physical therapy (neuromuscular re-education)
Facility: Morris County Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $61
- Cash Discount Price: $59
- vs. Medicare Baseline: 1.86x 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 |
|---|---|---|
| Coventry Mcr | $38 | 116% |
| Va Ccn-All Plans | $38 | 116% |
| Blue Cross Blue Shield | $38 - $50 | 116% |
| UnitedHealthcare | $38 - $98 | 116% |
| Choice Care Mcr Adv-All Plans | $38 | 116% |
| Cigna | $71 | 217% |
| Coventry Comm-All Other Plans | $88 | 269% |
| Aetna | $88 | 269% |
| Multiplan-All Plans | $88 | 269% |
| Providrs Care (Wppa)(Nexus)-All Plans | $147 | 449% |
Consumer Guidance & Cost Commentary
For this physical therapy service at Morris County Hospital in Council Grove, Kansas, the cash price of $59.00 is significantly lower than the median negotiated rate of $61.00 paid by insurance companies. While the facility is a Critical Access Hospital with government local ownership, patients should be aware that commercial payers like UnitedHealthcare and Blue Cross Blue Shield have negotiated ranges extending up to $98.00 and $50.00 respectively, which often exceed the cash price. Because the cash rate is lower than the average negotiated amount, patients with high-deductible plans may find it financially advantageous to pay out-of-pocket directly, provided they can afford the upfront cost and have verified that their insurance would not cover the service or would require them to meet a deductible first.
When reviewing your bill, it is crucial to distinguish between the hospital's gross charge of $98.00 and the actual amounts paid by insurers, as the difference represents administrative costs and contract terms rather than the true cost of care. The Medicare benchmark rate of $32.73 serves as a reliable baseline for evaluating pricing fairness, showing that the cash price is roughly 80% of the Medicare amount, which aligns with fair pricing standards rather than the typical 200% to 300% markup often seen in commercial billing. If you receive a bill that includes charges for services not rendered or items that should be bundled, you should request a full itemized audit before paying, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute. Additionally, if you are self-paying, ask the billing department about prompt-pay discounts, which can further reduce the