CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Insight Hospital and Medical Center Coldwater

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $101
  • Cash Discount Price: $115
  • vs. Medicare Baseline: 3.09x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Insight Hospital and Medical Center Coldwater is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.09x the Medicare baseline. Located in 274 E Chicago St, Coldwater, MI.
Cash / Self-Pay
$115

Average discount available for prompt cash payment at this facility.

Insurance Median
$101

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: $115 (351%)
Insurance Median: $101 (309%)
Cash: $115 (351% of Medicare)
Ins. Median: $101 (309% 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 309% of the Medicare baseline (a markup of 209%). 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.

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 $101 309%
Blue Cross Blue Shield $101 309%
Cofinity $101 309%
Frontpath $101 309%
Hap $101 309%
Health Alliance Plan $101 309%
Humana $101 309%
Mclaren $101 309%
Medicaid / KanCare $101 309%
Medicare (plans) $101 309%
Multi-Plan $101 309%
Paramount Elite $101 309%
Paramount Hmo $101 309%
Paramount Ppo $101 309%
Phcs $101 309%
Php Northern Indiana $101 309%
Php Of Mid Michigan $101 309%
Priority $101 309%
UnitedHealthcare $101 309%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 274 E Chicago St, Coldwater, MI 49036
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals