CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Avoyelles Hospital
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $62
- Cash Discount Price: $21
- vs. Medicare Baseline: 1.89x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Avoyelles Hospital is $62. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $21. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.89x the Medicare baseline. Located in 4231 Highway 1192, Marksville, LA.
Cash / Self-Pay
$21
Average discount available for prompt cash payment at this facility.
Insurance Median
$62
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: $21 (64%)
Insurance Median: $62 (189%)
Cash: $21 (64% of Medicare)
Ins. Median: $62 (189% 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
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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 | $14 - $48 | 43% |
| Cigna | $14 - $39 | 43% |
| Correct Cr Int Hlt | $14 | 43% |
| Mcd Amerihealth Caritas | $14 | 43% |
| Mcd Healthy Blue | $14 | 43% |
| Mcd La Hc Conn | $14 | 43% |
| Medicaid / KanCare | $14 | 43% |
| UnitedHealthcare | $14 - $31 | 43% |
| Mcd Ms | $16 | 49% |
| Student Assurances | $21 - $69 | 64% |
| All Savers | $25 | 76% |
| Geha | $25 | 76% |
| Humana | $25 - $39 | 76% |
| United Hlth One | $25 | 76% |
| Bankers Life | $31 | 95% |
| Champva | $31 | 95% |
| Mcr Lagniappe | $31 | 95% |
| Medeico Ins Co | $31 | 95% |
| Medicare (plans) | $31 | 95% |
| Mmc Allwell | $31 | 95% |
| Mmc Blue Advantage | $31 | 95% |
| Mmc Healthy Blue Dual Adv | $31 | 95% |
| Mmc Mcr Hmo Miscellaneous | $31 | 95% |
| Mmc Priority Hlth Pffs | $31 | 95% |
| Mmc Vantage Hlth | $31 | 95% |
| Mmc Wellcare | $31 | 95% |
| Mutual Of Omaha | $31 | 95% |
| Neba Inc | $31 | 95% |
| Philadelphia American Lif | $31 | 95% |
| Sentinel Security Life | $31 | 95% |
| Trustmark Health Benefits | $31 - $69 | 95% |
| Tunica Biloxi | $31 - $69 | 95% |
| United Amer Ins | $31 | 95% |
| Veterans Evaluation Serv | $31 | 95% |
| Wps Vacca | $31 | 95% |
| Amer Contl Ins | $32 - $48 | 98% |
| Coventry | $32 - $48 | 98% |
| First Choice Health | $32 - $48 | 98% |
| Meritan Health | $32 - $69 | 98% |
| Gulf South Zelis | $40 | 122% |
| Ppo Plus Llc | $41 | 125% |
| Zelis Healthcare Bpa | $41 | 125% |
| Gilsbar | $43 | 131% |
| Blue Cross Blue Shield | $54 | 165% |
| Ofc Of Grp Bene | $54 | 165% |
| Amerind | $62 | 189% |
| Applied Underwriters | $62 | 189% |
| Sedgwick | $62 | 189% |
| Us Dept Of Labor | $62 | 189% |
| Wc Clms Admin Svcs | $62 | 189% |
| Wc Clms Mgmnt Walmart | $62 | 189% |
| Wc Esis | $62 | 189% |
| Wc Fara | $62 | 189% |
| Wc Gallagher Bassett | $62 | 189% |
| Wc Guide One | $62 | 189% |
| Wc Hartford Med | $62 | 189% |
| Wc Luba | $62 | 189% |
| Wc Lwcc | $62 | 189% |
| Wc Paragon Casino Resort | $62 | 189% |
| Wc Risk Mgmnt | $62 | 189% |
| Wc Stone Trust | $62 | 189% |
| Wc Summit Consulting Hold | $62 | 189% |
| Wc Travelers Ins | $62 | 189% |
| Wc Trs Workers Comp Claim | $62 | 189% |
| Wc Us Dol | $62 | 189% |
| Wc Zurich | $62 | 189% |
| Aarp | $69 | 211% |
| Admin Concepts | $69 | 211% |
| All Saints Hospice | $69 | 211% |
| All State | $69 | 211% |
| Allegiance Health Hospice | $69 | 211% |
| Allied Natl | $69 | 211% |
| Amfirst | $69 | 211% |
| Avoy Parish School Board | $69 | 211% |
| Avoyelles Parish Sheriff | $69 | 211% |
| Bollinger | $69 | 211% |
| Ccmsi | $69 | 211% |
| Central States | $69 | 211% |
| Christus Health Plan | $69 | 211% |
| Compassionate Care Hospic | $69 | 211% |
| Core Source | $69 | 211% |
| Coushatta Hlth Dept | $69 | 211% |
| Ebms | $69 | 211% |
| Federated Ins | $69 | 211% |
| Feedom Life | $69 | 211% |
| Fidelity Standard Life Co | $69 | 211% |
| Fox Everette | $69 | 211% |
| Guarantee Trust | $69 | 211% |
| Heart Of Hospice | $69 | 211% |
| Hos Christus Hospice | $69 | 211% |
| Hos Guardian Hospice Care | $69 | 211% |
| Hos Harbor Hospice Alex | $69 | 211% |
| Hos La Hospice Palliative | $69 | 211% |
| Hos Passages Hospice N. | $69 | 211% |
| Hos St Joseph Hospice | $69 | 211% |
| Hospice Miscellaneous | $69 | 211% |
| Ins Mgmnt Admin | $69 | 211% |
| Ins Tpa | $69 | 211% |
| Liberty Health Share | $69 | 211% |
| Lumico | $69 | 211% |
| Manhattan Life Ins | $69 | 211% |
| Medi Share | $69 | 211% |
| Misc Comm | $69 | 211% |
| Nalc | $69 | 211% |
| New Era Life | $69 | 211% |
| North American | $69 | 211% |
| Phcs | $69 | 211% |
| Physicians Mutual | $69 | 211% |
| Pipeline Ind Bene | $69 | 211% |
| Progressive Auto | $69 | 211% |
| Reliance Standard Life | $69 | 211% |
| Rural Carriers | $69 | 211% |
| Shelter Ins Co | $69 | 211% |
| Sierre Health And Life | $69 | 211% |
| State Farm | $69 | 211% |
| State Mutual | $69 | 211% |
| Sterling Investors | $69 | 211% |
| The Health Plan | $69 | 211% |
| Tribal Hlth Partners | $69 | 211% |
| Tricare | $69 | 211% |
| Uct | $69 | 211% |
| Unified Life | $69 | 211% |
| Usaa Life Ins | $69 | 211% |
| Web-Tpa | $69 | 211% |
| Woodmen Of The World | $69 | 211% |