CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mary Free Bed Rehabilitation Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $79
Cash Discount Price: $123
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mary Free Bed Rehabilitation Hospital is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $123. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.41x the Medicare baseline. Located in 235 Wealthy St Se, Grand Rapids, MI.

Cash / Self-Pay

$123

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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: $123 (376%)

Insurance Median: $79 (241%)

Cash: $123 (376% of Medicare)

Ins. Median: $79 (241% 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 241% of the Medicare baseline (a markup of 141%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$18 - $93	55%
Blue_Cross_Blue_Shield_Of_Michigan	$18 - $163	55%
Healthplus_Partners	$18 - $22	55%
Mclaren_Health_Plan_Inc	$18 - $80	55%
Meridian_Health_Plan	$18 - $32	55%
Midwest_Health_Plan	$18 - $22	55%
Molina_Healthcare	$18 - $32	55%
Priority_Health	$18 - $101	55%
United_Healthcare	$18 - $214	55%
Health_Alliance_Plan_(Hap)	$32 - $42	98%
Humana	$32	98%
University_Of_Michigan_Health_Plan	$32 - $96	98%
Asr	$42	128%
Cigna	$94 - $118	287%
Multiplan	$105 - $114	321%
Three_Rivers_Provider_Network_Trpn	$108 - $113	330%

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 $123.
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 Mary Free Bed Rehabilitation 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.