CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Garrett Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $87
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Garrett Regional Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.66x the Medicare baseline. Located in 251 North Fourth Street, Oakland, MD.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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%)
Insurance Median: $87 (266%)
Ins. Median: $87 (266% 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 266% of the Medicare baseline (a markup of 166%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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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
Caresource Wv $69 - $108 211%
Aetna $71 - $120 217%
Carefirst D-Snp $71 - $111 217%
Carefirst Ppo $71 - $111 217%
Humana $71 - $111 217%
Medicare (plans) $71 - $111 217%
Provider Partners $71 - $111 217%
Senior Advantage $71 - $111 217%
United Mine Workers Of America $71 - $120 217%
UnitedHealthcare $71 - $120 217%
Amerigroup $73 - $113 223%
Carefirst Community Health Plan $73 - $113 223%
Coventry $73 - $113 223%
Highmark Health Options Wv $73 - $113 223%
Maryland Physicians Care $73 - $113 223%
Multiplan $73 - $114 223%
The Health Plan Of Wv $73 - $113 223%
Wellpoint Wv $73 - $113 223%
Upmc Commercial $76 - $119 232%
Alliance Coal $77 - $120 235%
American Correctional Healthcare $77 - $120 235%
Carefirst Commercial $77 - $120 235%
Cigna $77 - $120 235%
First Health $77 - $120 235%
John Hopkins Healthcare $77 - $120 235%
Peak Commercial $77 - $120 235%
Stratose/ 4 Most $77 - $120 235%
The Health Plan $77 - $120 235%
The Health Plan Commercial $77 - $120 235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 251 North Fourth Street, Oakland, MD 21550
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals