Physical therapy (neuromuscular re-education)
Facility: Children'S Mercy South
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $74
- Cash Discount Price: $67
- vs. Medicare Baseline: 2.26x 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 226% of the Medicare baseline (a markup of 126%). 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 |
|---|---|---|
| Cigna | $14 - $107 | 43% |
| UnitedHealthcare | $27 - $103 | 82% |
| Healthy Blue | $29 - $89 | 89% |
| Medicaid / KanCare | $29 - $32 | 89% |
| Home State Health | $36 - $78 | 110% |
| Quiktrip | $39 - $100 | 119% |
| Wppa Providrs Care | $40 - $100 | 122% |
| Blue Cross Blue Shield | $40 - $114 | 122% |
| Healthlink | $42 - $136 | 128% |
| Health Midwest Comprehensive Care | $46 - $100 | 141% |
| American Healthcare Alliance | $47 - $131 | 144% |
| Aetna | $50 - $105 | 153% |
| Multiplan | $51 - $117 | 156% |
| Humana | $60 - $102 | 183% |
| Orscheln | $61 - $100 | 186% |
| Wellfit/Centrus | $63 - $100 | 192% |
| Coventry Health Care Of Kansas | $64 - $114 | 196% |
| Centivo | $65 - $100 | 199% |
| Nebraska Furniture Mart | $65 - $100 | 199% |
| Medica | $74 - $90 | 226% |
| Mercy Health | $93 - $116 | 284% |
| Coxhealth Network | $94 - $114 | 287% |
| National Preferred Provider Network | $112 - $139 | 342% |
Consumer Guidance & Cost Commentary
For the CPT code 97112, representing neuromuscular re-education physical therapy at Children's Mercy South in Overland Park, KS, the facility's cash median rate is $67.00. This cash price is notably lower than the facility's negotiated rates, which range from $14 to $139 across 23 different payers, with the highest negotiated amount reaching $139 for the National Preferred Provider Network. While the facility's cash rate is significantly lower than the gross charge of $141, patients should be aware that commercial insurance negotiated rates often exceed cash prices due to administrative overhead and contract structures. Consequently, individuals with high-deductible plans or those who have not yet met their deductible may find paying the cash price directly more cost-effective than relying on insurance, which could result in higher out-of-pocket costs if the allowed amount surpasses the cash rate.
To minimize potential financial exposure, patients should proactively inquire about "self-pay" or "prompt-pay" discounts before scheduling services, as these upfront payment incentives can further reduce the total cost. It is also important to understand that while the No Surprises Act protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities, unexpected charges can still arise from ancillary services or out-of-network specialists. If a patient receives an itemized bill, they should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Finally, when evaluating the facility's pricing, it is more accurate to compare rates against the Medicare benchmark of $32.7