CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: T J Samson Community Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $32
Cash Discount Price: $55
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at T J Samson Community Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $55. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 1301 North Race Street, Glasgow, KY.

Cash / Self-Pay

$55

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$32.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $32.73 (100%)

Cash / Self-Pay: $55 (168%)

Insurance Median: $32 (98%)

Cash: $55 (168% of Medicare)

Ins. Median: $32 (98% of 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$22	67%
Humana	$22 - $31	67%
Molina Mcaid	$22	67%
Wellcare Mcaid	$30	92%
Blue Cross Blue Shield	$31 - $72	95%
Signature Health - All Plans	$31	95%
Wellcare Mcr Adv - All Other Plans	$31	95%
Molina Mcr Adv	$32	98%
Devoted Mcr Adv - All Plans	$33	101%
Caresource - All Plans	$46	141%
Molina Marketplace - All Other Plans	$46	141%
UnitedHealthcare	$66	202%
Center Care Select - All Plans	$72	220%
Phcs/Multiplan - All Plans	$80	244%
First Health - All Plans	$81	247%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $55.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

Insurance In-Network Protection Plan

Contact your insurance company to confirm T J Samson Community Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97112.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.