CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mercy Hospital Lebanon

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $148
Cash Discount Price: $127
vs. Medicare Baseline: 4.52x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mercy Hospital Lebanon is $148. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.52x the Medicare baseline. Located in 100 Hospital Drive, Lebanon, MO.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$148

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: $127 (388%)

Insurance Median: $148 (452%)

Cash: $127 (388% of Medicare)

Ins. Median: $148 (452% 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 452% of the Medicare baseline (a markup of 352%). 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
Medicaid / KanCare	$27 - $62	82%
Aetna	$29 - $154	89%
Blue Cross Blue Shield	$29 - $492	89%
Centivo Contracted [320505]	$29	89%
Champva [20065]	$29	89%
Cherokee Nation Health Serv Contracted [320066]	$29	89%
Cigna	$29 - $152	89%
Cross Timbers Hospice [20098]	$29	89%
Dept Of Veteran Affairs Contracted [320106]	$29	89%
Elara Caring Aspire Hospice [20433]	$29	89%
Globalhealth Contracted [320145]	$29	89%
Halo Hcr Inc Hospice Contracted [320432]	$29	89%
Halo Hcr Inc Hospice [20432]	$29	89%
Humana	$29 - $174	89%
Kindful Hospice Contracted [320434]	$29	89%
Kindful Hospice [20434]	$29	89%
Medicare (plans)	$29 - $32	89%
Mercy Hospice Okc [20252]	$29	89%
Mercy Mgd Behavioral Health Contracted [320259]	$29	89%
Pace Of The Ozarks Contracted [320518]	$29	89%
Provider Partners Health Plans Contracted [320450]	$29	89%
Qual Choice Contracted [320325]	$29	89%
Tricare	$29	89%
UnitedHealthcare	$29 - $195	89%
Healthscope Contracted [320182]	$37	113%
Ambetter / Centene	$56 - $62	171%
Home State Health Plan Contracted [320187]	$56 - $62	171%
Novasys Contracted [320285]	$56 - $62	171%
Medica Contracted [320239]	$73 - $81	223%
Medica [20239]	$73 - $81	223%
Administrative Payor Contracted [320005]	$83 - $92	254%
Healthlink Contracted [320179]	$120 - $174	367%
Preferred Health Plan Contracted [320522]	$120 - $133	367%
90 Degree Benefits Contracted [320436]	$139 - $154	425%
Mercy Benefit Admin Contracted [320251]	$139 - $164	425%
Show-Me Health Administrators Contracted [320483]	$139 - $154	425%
United Medical Resources Contracted [320454]	$139 - $164	425%
Aither Health Contracted [320449]	$148 - $164	452%
Auxiant Contracted [320462]	$148 - $164	452%
Benefit Management Contracted [320052]	$148 - $164	452%
Ebms Contracted [320493]	$148 - $164	452%
Edison Health Solutions Contracted [320502]	$148 - $164	452%
Evolutions Health Care Contracted [320124]	$148 - $164	452%
First Health Contracted [320128]	$148 - $164	452%
Health Systems Inc Contracted [320174]	$148 - $164	452%
Imagine 360 Contracted [320494]	$148 - $164	452%
Insurance System Inc Contracted [320465]	$148 - $164	452%
Point C Contracted [320238]	$148 - $195	452%
Point C [20238]	$148 - $164	452%
Reflect Health Contracted [320492]	$148 - $164	452%
Workers Comp [20426]	$148 - $174	452%
Yuzu Health Contracted [320521]	$148 - $164	452%
American Healthcare Alliance Contracted [320020]	$157 - $174	480%
Usa Managed Care Org Contracted [320429]	$163 - $180	498%
Multiplan Contracted [320270]	$176 - $195	538%
Private Health Care Systems Contracted [320320]	$176 - $195	538%

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 $127.
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 Mercy Hospital Lebanon 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.