Physical therapy (neuromuscular re-education)
Facility: Neosho Memorial Regional Medical Center
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $54
- Cash Discount Price: $126
- vs. Medicare Baseline: 1.65x 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 |
|---|---|---|
| Medicaid / KanCare | $27 | 82% |
| Tricare | $52 | 159% |
| Va_Ccn | $54 | 165% |
| Humana | $54 | 165% |
| Blue Cross Blue Shield | $54 - $56 | 165% |
| Medadv_Uhc | $54 | 165% |
| Aetna | $54 | 165% |
| Medadv_Allwell | $54 | 165% |
| Medicare (plans) | $54 | 165% |
| Ambetter / Centene | $84 | 257% |
| Wppa_Providrscare | $139 | 425% |
| United | $139 | 425% |
| Cigna | $159 | 486% |
| Hpk | $159 | 486% |
| Coventry | $159 | 486% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy, Neosho Memorial Regional Medical Center in Chanute, KS, lists a cash median price of $126.00 and a median negotiated rate of $54.00 across 15 payers. While the facility is a Critical Access Hospital with government-local ownership, patients should note that cash-pay options can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront incentives can significantly reduce out-of-pocket costs by bypassing administrative fees and claims processing delays.
The data indicates that the facility's negotiated rates vary by payer, ranging from $27 for Medicaid/KanCare to $159 for carriers like Cigna and Coventry, with a gross chargemaster of $168.00. When evaluating these costs, it is important to compare them against the Medicare benchmark of $32.73, which serves as a scientifically validated baseline for the true cost of care rather than the inflated chargemaster list. Although the report does not provide specific state or county average figures for this procedure, understanding that commercial rates often average 200% to 300% of Medicare highlights the potential for significant savings through direct negotiation or prompt payment. Consumers are encouraged to request an itemized billing audit if they receive a summary bill, as over 80% of hospital invoices contain errors such as unbundled codes or services not rendered that can be corrected to lower