CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Charlevoix Area Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $65
Cash Discount Price: $69
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Charlevoix Area Hospital is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.99x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$69

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $69 (211%)

Insurance Median: $65 (199%)

Cash: $69 (211% of Medicare)

Ins. Median: $65 (199% 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
Blue Cross Blue Shield	$22 - $75	67%
Mclaren Health Plan	$22 - $75	67%
Meridian	$22	67%
Priority Health	$22 - $85	67%
UnitedHealthcare	$22 - $70	67%
Aetna	$31 - $73	95%
Blue Care Network	$31 - $38	95%
Hap (Health Alliance Plan)	$31 - $65	95%
Medicare (plans)	$31 - $38	95%
Michigan Amish Medical Board	$31 - $38	95%
Molina	$31 - $41	95%
Northern Michigan Mennonite Group	$31 - $38	95%
Provider Network Of America/Hma Group Health	$44 - $69	134%
Asr Physicians Care Network	$47 - $65	144%
Hospice Of Michigan	$49	150%
Nomi Health	$50 - $75	153%
Employee Benefits Logistics	$53 - $65	162%
Enterprise Group Planning Employee Benefit Plan	$65	199%
First Health/Coventry Health/Community Care Network	$65	199%
Medical Cost Savings Solution	$65	199%
Three Rivers Provider Network	$69	211%
Cofinity	$75	229%
Iba Health And Life Assurance Company	$75	229%
Preferred Medical Claim Solutions	$77	235%
Cigna	$81 - $85	247%

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 $69.
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 Charlevoix Area Hospital 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.