CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Promedica Monroe Regional Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $60
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Promedica Monroe Regional Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.83x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $83 (254%)
Insurance Median: $60 (183%)
Cash: $83 (254% of Medicare)
Ins. Median: $60 (183% 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
Meridian $17 52%
Priority Health $17 - $70 52%
Aetna $18 - $90 55%
Blue Cross Blue Shield $18 - $72 55%
Molina Healthcare Of Michigan $18 55%
UnitedHealthcare $19 - $104 58%
Paramount Healthcare Inc $30 - $97 92%
Health Alliance Plan $31 - $105 95%
Veterans Affairs $31 95%
Humana $32 98%
Amerihealth $59 180%
Frontpath $74 226%
Encore Health Network $90 275%
Health Ohio Network, Llc $90 275%
Cofinity $91 278%
Multiplan $115 351%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 718 N Macomb St, Monroe, MI 48162
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals