CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Lake Charles Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $33
Cash Discount Price: $51
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Lake Charles Memorial Hospital is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 1701 Oak Park Blvd, Lake Charles, LA.

Cash / Self-Pay

$51

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: $51 (156%)

Insurance Median: $33 (101%)

Cash: $51 (156% 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	$11 - $114	34%
Medicaid / KanCare	$11 - $18	34%
Meritain	$30 - $46	92%
Blue Cross Blue Shield	$32	98%
Champus_Va	$32	98%
Cigna	$32 - $77	98%
Medicare (plans)	$32	98%
Tricare	$32	98%
Verity	$32 - $49	98%
Veterans_Administration	$32	98%
Veterans_Choice-Triwest	$32	98%
Humana	$33 - $113	101%
Ppo_Plus_	$40 - $62	122%
Phcs	$47 - $72	144%
United_Healthcare_Behavorial_Health	$47 - $72	144%
Lwcc	$51 - $79	156%
First_Health	$54 - $82	165%
Coushatta_Tribe_Dept_Of_Health	$58	177%
Workers_Compensation	$61 - $93	186%
Blue_Cross_Blue_Shield_La	$72	220%
Vantage_Commercial	$74	226%
United_Healthcare	$191	584%

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 $51.
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 Lake Charles Memorial 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.