CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Boston Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $40
  • Cash Discount Price: $151
  • vs. Medicare Baseline: 1.22x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Boston Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.22x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.
Cash / Self-Pay
$151

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $151 (461%)
Insurance Median: $40 (122%)
Cash: $151 (461% of Medicare)
Ins. Median: $40 (122% 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.

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
Workers Comp [5002] $24 73%
Zzzbu Employee Work Comp [5004] $24 73%
Zzzcity Of Boston Work Comp [5003] $24 73%
Aetna $36 - $164 110%
Blue Cross Blue Shield $36 - $216 110%
Humana $36 110%
Medicare (plans) $36 - $38 110%
Neighborhood Pace [1206] $36 110%
Oxford Health [1007] $36 110%
Oxford Health [2024] $36 110%
Tufts [8002] $36 - $110 110%
Ubh Hphc [8016] $36 110%
United [2025] $36 - $145 110%
UnitedHealthcare $36 110%
Veterans Admin [9003] $36 110%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010] $36 110%
Zzzunited [1008] $36 - $145 110%
Cca [1215] $38 116%
Champva [9004] $38 116%
Corrections [9001] $38 - $46 116%
Tricare $38 116%
Wellcare [1240] $38 116%
Zzzcca Onecare [1216] $38 116%
Eternalhealth [1227] $39 119%
Fallon Sco [1126] $40 122%
Senior Whole Health [1210] $44 134%
Fallon [8008] $47 144%
Unicare [8004] $51 156%
Wellpoint [2034] $51 156%
Tufts Conncare/Qhp [8020] $52 - $431 159%
Cigna $110 - $285 336%
Medicaid / KanCare $121 370%
Uphams Corner Esp [1213] $134 409%
Harvard Pilgrim Health Care [8001] $145 443%
Health Plans Inc [2027] $145 443%
Zzzhealth Plans Inc [1013] $145 443%
Meritain Health [1023] $164 501%
Mass General Brigham Health Plan Commercial [8009] $181 553%
Hsn Bad Debt [4003] $513 1567%
Hsn Confidential [4007] $513 1567%
Hsn Dental [4006] $513 1567%
Hsn Partial [4002] $513 1567%
Hsn [4001] $513 1567%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Boston Medical Center Place, Boston, MA 02118
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals