CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Barnes Jewish Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $80
Cash Discount Price: $64
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Barnes Jewish Hospital is $80. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $64. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.44x the Medicare baseline. Located in One Barnes-Jewish Hospital Plaza, Saint Louis, MO.

Cash / Self-Pay

$64

Average discount available for prompt cash payment at this facility.

Insurance Median

$80

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: $64 (196%)

Insurance Median: $80 (244%)

Cash: $64 (196% of Medicare)

Ins. Median: $80 (244% 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 244% of the Medicare baseline (a markup of 144%). 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	$31 - $351	95%
Blue Cross Blue Shield	$31 - $92	95%
Essence Healthcare [221]	$31	95%
Humana	$31 - $69	95%
UnitedHealthcare	$31 - $205	95%
Cox Health [757]	$33	101%
Devoted Health Plan [847]	$33	101%
Medica [662]	$33	101%
Healthlink [225]	$51 - $80	156%
Cox Health Systems Insurance Company [220]	$58 - $69	177%
Health Alliance [224]	$58	177%
Allied Benefits [498]	$61 - $351	186%
Hope Trust [806]	$61	186%
Healthscope Benefits [258]	$69 - $205	211%
Med-Pay [480]	$69 - $80	211%
Unicare [568]	$69 - $80	211%
First Health Commercial [734]	$79	241%
Beechstreet [551]	$80	244%
Detego Health [868]	$80	244%
Health Systems Inc [620]	$80	244%
Healthcare Sol Mercy [609]	$80	244%
Multiplan Commercial [737]	$80	244%
Multiplan [240]	$80	244%
Phcs [244]	$80 - $85	244%
Preferred Health Professionals [561]	$80	244%
Cigna	$85 - $199	260%
Medica [661]	$85	260%
Hfn [563]	$90	275%
Consociate [478]	$114	348%
Sarah Bush Lincoln [636]	$114	348%
Apwu Health Plan [216]	$173	529%
Nalc Health Benefit Plan [242]	$173	529%
Priority Health [648]	$173	529%
Coresource [497]	$351	1072%
Fmh Benefit Service Inc [222]	$351	1072%
Mail Handlers [495]	$351	1072%

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 $64.
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 Barnes Jewish 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.