CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: North Oaks Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $30
Cash Discount Price: $76
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at North Oaks Medical Center is $30. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $76. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.92x the Medicare baseline. Located in 15790 Paul Vega Md Drive, Hammond, LA.

Cash / Self-Pay

$76

Average discount available for prompt cash payment at this facility.

Insurance Median

$30

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: $76 (232%)

Insurance Median: $30 (92%)

Cash: $76 (232% of Medicare)

Ins. Median: $30 (92% 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	$20 - $241	61%
Humana	$20 - $213	61%
Mco Hb	$20	61%
Mco Lacare Am	$20	61%
Mco Lhc	$20	61%
Medicaid / KanCare	$20	61%
UnitedHealthcare	$20 - $147	61%
Allwell	$30	92%
Blue Advantage	$30	92%
Champva	$30	92%
Healthy Blue Dual Advantage	$30	92%
Peoples Health	$30	92%
Tricare	$30 - $31	92%
Vantage 65	$30	92%
Veterans Administration	$30	92%
Wellcare	$30	92%
Blue Cross Blue Shield	$75 - $76	229%
Verity Healthnet	$185	565%
Ppoplus Llc	$199	608%
Multiplan	$213	651%
Cigna	$224	684%

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 $76.
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 North Oaks Medical Center 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.