CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Northeast Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $177
  • Cash Discount Price: $197
  • vs. Medicare Baseline: 5.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Northeast Regional Medical Center is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.41x the Medicare baseline. Located in 315 S Osteopathy, Kirksville, MO.
Cash / Self-Pay
$197

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $197 (602%)
Insurance Median: $177 (541%)
Cash: $197 (602% of Medicare)
Ins. Median: $177 (541% 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 541% of the Medicare baseline (a markup of 441%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $28 - $46 86%
Medicare (plans) $30 92%
Node Champva $30 92%
Tricare $30 92%
Veterans Eval Services $30 92%
Blue Access $31 95%
Blue Cross Blue Shield $31 - $152 95%
Blue Pathway/Pathway X $31 95%
Blue Prefrerred $31 95%
Node Hospice Non Par Agree $31 95%
Node Va $31 95%
UnitedHealthcare $31 - $374 95%
Node Devoted Health Mcr Adv $32 98%
Centurion Correctional $38 116%
Us Department Of Labor $48 147%
Home State Exchange $55 168%
Naphcare $58 177%
Immergrun $61 186%
Self Pay $120 - $274 367%
Cigna $169 - $195 516%
Aetna $185 - $415 565%
Access Health Services, Llc $324 990%
Healthlink $374 - $398 1143%
Multiplan $374 - $398 1143%
Coventry Wc $398 1216%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 S Osteopathy, Kirksville, MO 63501
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals