CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Essentia Health Northern Pines Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $68
Cash Discount Price: $72
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Essentia Health Northern Pines Medical Center is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.08x the Medicare baseline. Located in 5211 Highway 110, Aurora, MN.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $72 (220%)

Insurance Median: $68 (208%)

Cash: $72 (220% of Medicare)

Ins. Median: $68 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Itasca Med Care	$32	98%
Primewest	$34	104%
Advocare/Security Health	$38	116%
Blue Cross Blue Shield	$38 - $79	116%
Blue Plus Pmap Pcc Prime	$38 - $54	116%
Freedom Blue Ppo	$38	116%
Healthpartners Care Msho / Mcr Adv	$38	116%
Imcare Msho Pcc Prime	$38	116%
Imcare Msho Ref Req	$38	116%
Medica Advantage Solutions	$38	116%
Medica Msho/Dual Solutions	$38	116%
Medica Prime Solution Group	$38	116%
Medicare (plans)	$38	116%
Nd Va Administration	$38	116%
Platinum Blue/Vantage Blue	$38	116%
Primewest Msho	$38	116%
Secure Blue Msho	$38	116%
Ubh Cost Plan	$38	116%
Ubh Msho	$38	116%
Ucare Msho	$38	116%
UnitedHealthcare	$38 - $89	116%
Healthpartners Care Pmap	$39	119%
Medica Access	$39 - $61	119%
Sanford Healthplan	$42 - $44	128%
Ucare	$64	196%
Healthpartners	$66 - $78	202%
Medica	$70 - $78	214%
Medica Uplan	$70	214%
Wea	$71 - $75	217%
America'S Ppo	$76	232%
Cigna	$76 - $78	232%
Healthpartners Pcc Prime	$76 - $78	232%
Medica Choice	$80	244%
Wps	$81 - $82	247%
Aetna	$83	254%
Healtheos	$84	257%
Security Health	$98	299%

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 $72.
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 Essentia Health Northern Pines Medical Center 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.