CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Greater Baltimore Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $35
Cash Discount Price: $91
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Greater Baltimore Medical Center is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 6701 North Charles Street, Baltimore, MD.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$35

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: $91 (278%)

Insurance Median: $35 (107%)

Cash: $91 (278% of Medicare)

Ins. Median: $35 (107% 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.

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
Aetna	$27 - $37	82%
Alterwood Health [290]	$27	82%
Md Physician Care [237]	$27	82%
Medicaid / KanCare	$27	82%
Priority Partners [241]	$27	82%
UnitedHealthcare	$27 - $37	82%
Wellpoint [235]	$27	82%
Jai Medical Services [236]	$28	86%
Cigna	$31 - $35	95%
Carefirst Blue Choice Hmo [253]	$35	107%
Carefirst Maryland Health Advantage Mca [264]	$35	107%
Carefirst [201]	$35 - $38	107%
Cfchp Mco [239]	$35	107%
Communicare Advantage [300]	$35	107%
Humana	$35	107%
Johns Hopkins [213]	$35 - $47	107%
Keycare Advantage [299]	$35	107%
Medicare (plans)	$35	107%
Provider Partners Health Plan [298]	$35	107%
Carefirst Administrator [252]	$38	116%
Multiplan/Phcs [296]	$41	125%
First Health Network [268]	$46	141%
Kaiser Permanente Hmo [231]	$50	153%
Usa Managed Care Organization [301]	$54	165%
All Payers	$117 - $126	357%

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 $91.
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 Greater Baltimore Medical Center 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.