CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ochsner American Legion Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $33
Cash Discount Price: $22
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ochsner American Legion Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $22. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 1634 Elton Road, Jennings, LA.

Cash / Self-Pay

$22

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $22 (67%)

Insurance Median: $33 (101%)

Cash: $22 (67% of Medicare)

Ins. Median: $33 (101% 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	$30 - $46	92%
Blue Cross Blue Shield	$30 - $72	92%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$30	92%
Humana	$30	92%
Medicare (plans)	$30	92%
Ochsner Health Plan	$30	92%
UnitedHealthcare	$30 - $139	92%
Wellcare Of Louisiana	$30	92%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$31	95%
Tricare	$32	98%
Verity Commercial And First Choice Network	$32	98%
Zelis	$49	150%
Provider Network Of America	$51	156%
Louisiana Workers' Compensation Corporation (Lwcc)	$53 - $908	162%
Healthcomp & Personify Health (Formerly Gilsbar)	$55	168%
Cigna	$100	306%

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 $22.
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 Ochsner American Legion 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.