CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: North Adams Regional Hospital Corporation

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $89
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at North Adams Regional Hospital Corporation is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$89

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $89 (272%)
Insurance Median: $63 (192%)
Cash: $89 (272% of Medicare)
Ins. Median: $63 (192% 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
Blue Cross Blue Shield $21 - $81 64%
Comm Hospice $21 - $34 64%
Mcr Miscellaneous $21 - $34 64%
Mcrmanaged Cca One Care $21 - $38 64%
Mcrmanaged Usa Family $21 - $34 64%
Mcrmanaged Va $21 - $34 64%
Medicaid / KanCare $21 - $147 64%
Medicare (plans) $21 - $36 64%
Oth United Vaccn $21 - $34 64%
Mcd Masshealth $26 - $147 79%
Mcd New York $26 - $73 79%
Mcd Out Of State $26 - $147 79%
Mcdmanaged Cdphp $26 - $147 79%
Mcdmanaged Hne Mcdaco $26 - $147 79%
Comm Network Qhpsub $28 - $54 86%
Mcdmanaged Network $28 - $54 86%
Mcdmanaged Bmchnp $30 - $153 92%
Tricare $33 - $36 101%
Aetna $40 - $72 122%
Comm Fallon Qhp $50 - $54 153%
Wc Workers Comp $56 - $58 171%
Comm Network Qhpnonsub $59 - $69 180%
Comm Nhp $60 - $62 183%
Comm Unicare $60 - $71 183%
Comm Hne Hmo $64 - $66 196%
Comm Hne $67 - $70 205%
Comm Hne Ppo $67 - $70 205%
Comm Tufts $73 - $76 223%
UnitedHealthcare $79 - $82 241%
Cigna $83 - $89 254%
Comm Cdphp $83 - $86 254%
Comm Mvp $83 - $86 254%
Comm Oxford $83 - $86 254%
Comm First Health $86 - $91 263%
Comm Connecticare $88 - $91 269%
Comm Consolidated Health $88 - $91 269%
Comm Harvard $88 - $91 269%
Comm Other $88 - $91 269%
Comm Phcs $88 - $91 269%
Comm Self Pay $88 - $91 269%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals