CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University of Louisville Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $74
Cash Discount Price: $44
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University of Louisville Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.26x the Medicare baseline. Located in 530 South Jackson Street, Louisville, KY.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $44 (134%)

Insurance Median: $74 (226%)

Cash: $44 (134% of Medicare)

Ins. Median: $74 (226% 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.

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.

Consult Patient Advocate

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
Blue Cross Blue Shield	$30 - $184	92%
Essence Health	$30	92%
Humana	$30 - $31	92%
Va Ccn	$30	92%
Aetna	$31	95%
Signature	$31 - $92	95%
UnitedHealthcare	$31 - $88	95%
Communicare	$32	98%
Devoted	$32 - $55	98%
Passport	$32 - $92	98%
Senior Care Community Of Ky	$32	98%
Wellcare	$35 - $44	107%
Key Benefit Administrators	$39	119%
Velocity	$39 - $180	119%
Prime Group Health	$51 - $156	156%
Cigna	$102	312%
Cshn	$120 - $184	367%
Multiplan	$121 - $166	370%
Encore	$129	394%
Health Smart	$138	422%
Omca	$175	535%
Corvel	$184	562%
National Comp Care	$184	562%

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 $44.
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 University of Louisville 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.