CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Hermann Area District Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $61
Cash Discount Price: $82
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Hermann Area District Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $82. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.86x the Medicare baseline. Located in 509 W 18Th St, Hermann, MO.

Cash / Self-Pay

$82

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $82 (251%)

Insurance Median: $61 (186%)

Cash: $82 (251% of Medicare)

Ins. Median: $61 (186% 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
Healthy Blue Mcaid - All Plans	$29	89%
Ambetter / Centene	$30 - $100	92%
Blue Cross Blue Shield	$31 - $106	95%
UnitedHealthcare	$31 - $106	95%
Harmony Hp Mcaid- All Plans	$50	153%
Care Partners Mcaid- All Plans	$52	159%
Tricare	$54	165%
Choicecare Mcr Adv- All Plans	$57	174%
American Hlth Mcr Adv- All Plans	$60	183%
Humana	$60	183%
Aetna	$61 - $129	186%
Wellcare Mcr Adv - All Plans	$61	186%
Cigna	$81	247%
Healthcare Usa Mcaid- All Plans	$88	269%
Healthlink Hmo	$88	269%
Healthlink Ppo - All Other Plans	$102	312%
Multiplan/Phcs - All Plans	$102	312%
Coventry - All Plans	$116	354%
Comp Results - All Plans	$122	373%
Three Rivers - All Plans	$122	373%

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 $82.
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 Hermann Area District 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.