CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Chelsea Hospital
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $116
- Cash Discount Price: $925
- vs. Medicare Baseline: 3.54x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Chelsea Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $925. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.54x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$925
Average discount available for prompt cash payment at this facility.
Insurance Median
$116
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: $925 (2826%)
Insurance Median: $116 (354%)
Cash: $925 (2826% of Medicare)
Ins. Median: $116 (354% 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 354% of the Medicare baseline (a markup of 254%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Blue Cross Blue Shield | $18 - $65 | 55% |
| Medicaid / KanCare | $18 | 55% |
| Aetna | $32 - $96 | 98% |
| Arbor Hospice | $32 - $130 | 98% |
| Blue Care Network Advantage | $32 | 98% |
| Medicare (plans) | $32 - $33 | 98% |
| Align Senior Care | $33 | 101% |
| Angela Hospice | $33 | 101% |
| Heartland Hospice | $33 | 101% |
| Cca - Zing Health | $34 | 104% |
| UnitedHealthcare | $34 - $118 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $37 | 113% |
| Molina Marketplace | $42 | 128% |
| Wc Accident Fund | $46 | 141% |
| Wc Advantage | $46 | 141% |
| Wc Aig | $46 | 141% |
| Wc Allied | $46 | 141% |
| Wc Amerisure | $46 | 141% |
| Wc Amtrust | $46 | 141% |
| Wc Asu Risk Mgt | $46 | 141% |
| Wc Berkley Admin | $46 | 141% |
| Wc Broadspire | $46 | 141% |
| Wc Bunch & Associates | $46 | 141% |
| Wc Ccmsi | $46 | 141% |
| Wc Emc Insurance Company | $46 | 141% |
| Wc Esis | $46 | 141% |
| Wc Fcci | $46 | 141% |
| Wc Federated | $46 | 141% |
| Wc Gallagher Bassett | $46 | 141% |
| Wc Genex Care For Ohio | $46 | 141% |
| Wc Guard Insurance Company | $46 | 141% |
| Wc Hartford | $46 | 141% |
| Wc Liberty Mutual | $46 | 141% |
| Wc Meijers | $46 | 141% |
| Wc Michigan | $46 | 141% |
| Wc Mitchell Frankenmuth | $46 | 141% |
| Wc Pma | $46 | 141% |
| Wc Sedgwick | $46 | 141% |
| Wc Sentry | $46 | 141% |
| Wc Travelers | $46 | 141% |
| Wc Tristar | $46 | 141% |
| Wc Walmart | $46 | 141% |
| Wc Zurich | $46 | 141% |
| U Of M Health Plan | $49 - $197 | 150% |
| Health Cost Solutions | $50 | 153% |
| Vitalcore | $50 | 153% |
| Wellpath | $50 | 153% |
| Priority Health | $63 - $280 | 192% |
| Bcn Domestic | $65 | 199% |
| Blue Benefit Administrators Of Massachusetts | $65 | 199% |
| Blue Care Network | $65 | 199% |
| Blue Distinction Transplant | $65 | 199% |
| Blue Shield - Ca | $65 | 199% |
| Blue Shield - Id (Regence) | $65 | 199% |
| Blue Shield - Ny Highmark Northeastern | $65 | 199% |
| Blue Shield - Ny Highmark Western | $65 | 199% |
| Blue Shield - Pa (Highmark) | $65 | 199% |
| Blue Shield - Wa (Regence) | $65 | 199% |
| Health Choices | $65 - $116 | 199% |
| Kaiser Domestic | $65 | 199% |
| Employee Benefit Logistic | $73 | 223% |
| Asr Health Benefits | $84 - $335 | 257% |
| Caresource | $84 - $335 | 257% |
| Hap | $84 - $335 | 257% |
| Varipro | $84 - $335 | 257% |
| Geha | $96 - $118 | 293% |
| Meritain | $96 | 293% |
| Access Health | $116 | 354% |
| Acclaim | $116 | 354% |
| Administrative Concepts | $116 | 354% |
| Allegeant | $116 | 354% |
| Ameriben | $116 | 354% |
| American Family | $116 | 354% |
| American Healthcare Alliance | $116 | 354% |
| American National | $116 | 354% |
| American Republic | $116 | 354% |
| Amerihealth | $116 | 354% |
| Aultcare | $116 | 354% |
| Automated Benefit Services | $116 | 354% |
| Auxiant | $116 | 354% |
| Benefit Administrative Systems,Llc | $116 | 354% |
| Boon Chapman | $116 | 354% |
| Cam Administrative Services | $116 | 354% |
| Christian Brother Services | $116 | 354% |
| Christian Brothers Holy Cross | $116 | 354% |
| Comprehensive Benefits | $116 | 354% |
| Continental Life Insurance | $116 | 354% |
| Custom Benefit Administrators | $116 | 354% |
| Employee Benefit Concepts | $116 | 354% |
| Employee Benefit Management | $116 | 354% |
| Enterprise Group Planning | $116 | 354% |
| Freedom Life Insurance Company | $116 | 354% |
| Group Administrators | $116 | 354% |
| Group Marketing Services | $116 | 354% |
| Guardian | $116 | 354% |
| Health America | $116 | 354% |
| Healthcare Management Admin | $116 | 354% |
| Healthez | $116 | 354% |
| Humana | $116 | 354% |
| Insight | $116 | 354% |
| Intercare | $116 | 354% |
| Jfp Benefit Management | $116 | 354% |
| Jp Farley Corporation | $116 | 354% |
| Key Benefit Administrator | $116 | 354% |
| Liberty Union Life Assurance Co | $116 | 354% |
| Lucent Health | $116 | 354% |
| Luminare Health | $116 | 354% |
| Luminare Health (Detroit) | $116 | 354% |
| Magnacare | $116 | 354% |
| Medben | $116 | 354% |
| Medcost | $116 | 354% |
| Medical Mutual | $116 | 354% |
| Mutual Health Services | $116 | 354% |
| Mutual Of Omaha | $116 | 354% |
| Ncas | $116 | 354% |
| Nippon Life Ins | $116 | 354% |
| Nova | $116 | 354% |
| Painters Union Insurance Fund | $116 | 354% |
| Physicians Mutual | $116 | 354% |
| Plumbers Local 98 Insurance Fund | $116 | 354% |
| Prairie States | $116 | 354% |
| Preferred One | $116 | 354% |
| Primary Physician Care | $116 | 354% |
| Professional Benefit Administrators | $116 | 354% |
| Siho Insurance Services | $116 | 354% |
| Sisco Benefits | $116 | 354% |
| The Loomis Company | $116 | 354% |
| Unicare | $116 | 354% |
| Us Health And Life | $116 | 354% |
| Valenz | $116 | 354% |
| Western & Southern Financial Group | $116 | 354% |
| Wps | $116 | 354% |
| Coventry | $120 | 367% |
| First Health | $120 | 367% |
| Hospice Of Michigan | $122 | 373% |
| Cigna | $123 | 376% |
| 1199 National Benefit Fund | $131 | 400% |
| Allied National Global Care | $131 | 400% |
| Asrm - Reliance Standard Life Insurance | $131 | 400% |
| Christian Care Ministry | $131 | 400% |
| Dean Health | $131 | 400% |
| Fallon Health | $131 | 400% |
| Family Life Insurance Company | $131 | 400% |
| Ghc Scw | $131 | 400% |
| Group Pension Administrators | $131 | 400% |
| International Benefit Administrators | $131 | 400% |
| Lifetime Benefit Solutions | $131 | 400% |
| Manhattan Life | $131 | 400% |
| Medi Share | $131 | 400% |
| Multiplan | $131 | 400% |
| Mvp | $131 | 400% |
| Pai | $131 | 400% |
| Pan-American Life | $131 | 400% |
| Paramount Hmo | $131 | 400% |
| Phcs | $131 | 400% |
| Trinity Health Share | $131 | 400% |
| Health Partners | $136 | 416% |
| Tufts Health Plan | $136 | 416% |
| Prime Health Services | $140 | 428% |
| Three Rivers Provider Network | $158 | 483% |
| Cmh Detroit Wayne Integrated Health Network | $175 | 535% |
| Cmh Jackson County/Lifeways | $175 | 535% |
| Cmh Lenawee County | $175 | 535% |
| Cmh Livingston County | $175 | 535% |
| Cmh Misc | $175 | 535% |
| Cmh Monroe County | $175 | 535% |
| Cmh Washtenaw County | $175 | 535% |
| Magellan Behavioral Health | $175 | 535% |