CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Cox Medical Centers

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $33
Cash Discount Price: $36
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Cox Medical Centers is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 3801 South National Avenue, Springfield, MO.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$33

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: $36 (110%)

Insurance Median: $33 (101%)

Cash: $36 (110% of Medicare)

Ins. Median: $33 (101% 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
Allwell	$31	95%
Blue Cross Blue Shield	$31	95%
Cox Healthplans	$31	95%
Health Net Federal Services	$31	95%
Humana	$31	95%
UnitedHealthcare	$31 - $254	95%
Devoted	$33	101%
Provider Partners Health Plan	$33	101%
Bjc Health Solutions	$77 - $145	235%
Compalliance	$100	306%
Medrisk Llc	$120	367%
Cigna	$326	996%

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 $36.
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 Cox Medical Centers 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.