CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ochsner Medical Center-Kenner

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $92
Cash Discount Price: $40
vs. Medicare Baseline: 2.81x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ochsner Medical Center-Kenner is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $40. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.81x the Medicare baseline. Located in 180 West Esplanade Avenue, Kenner, LA.

Cash / Self-Pay

$40

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $40 (122%)

Insurance Median: $92 (281%)

Cash: $40 (122% of Medicare)

Ins. Median: $92 (281% 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 281% of the Medicare baseline (a markup of 181%). 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
Medicaid / KanCare	$28 - $29	86%
Blue Cross Blue Shield	$31 - $96	95%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$31	95%
Humana	$31	95%
Medicare (plans)	$31	95%
Ochsner Health Plan	$31	95%
UnitedHealthcare	$31 - $365	95%
Wellcare Of Louisiana	$32	98%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$33	101%
Tricare	$33	101%
Zelis	$79	241%
Healthcomp & Personify Health (Formerly Gilsbar)	$86	263%
Claritev D/B/A Multiplan/Phcs/American Life Care	$92	281%
First Health Network	$107	327%
Louisiana Workers' Compensation Corporation (Lwcc)	$107	327%
Mississippi Physicians Care Network	$107	327%
Galaxy Health Network Ppo	$114	348%
Galaxy Health Network Wc	$114	348%
Employers Health Network (Ehn)	$122	373%
Prime Health Services Ppo	$122	373%
Usa Managed Care Network	$122	373%
Aetna	$188	574%
Cigna	$225	687%

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 $40.
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 Medical Center-Kenner 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.