CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Holmes County Hospital and Clinics

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $52
  • Cash Discount Price: $27
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Holmes County Hospital and Clinics is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.59x the Medicare baseline. Located in 239 Bowling Green Road, Lexington, MS.
Cash / Self-Pay
$27

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $27 (82%)
Insurance Median: $52 (159%)
Cash: $27 (82% of Medicare)
Ins. Median: $52 (159% 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.

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
Ms-Can-Molina-Lex $27 82%
Ms-Can-Magnolia-Lex $28 86%
Ms-Can-Truecare-Lex $28 86%
Advhealth-Lex $34 104%
Cigna $38 - $41 116%
Blue Cross Blue Shield $40 122%
Tricare $40 - $43 122%
Humana $41 - $44 125%
Mpcn-Lex $42 - $46 128%
Medadv_Uhc-Lex $44 - $48 134%
Firstchoice-Lex $46 - $49 141%
Ambetter / Centene $49 - $52 150%
Medadv_Primewell-Lex $49 - $52 150%
Medicare (plans) $49 - $52 150%
Primewell-Lex $49 - $52 150%
Va_Ccn-Lex $49 - $52 150%
Medadv_Uhcdsnp-Lex $50 - $54 153%
Wellcare-Lex $50 - $54 153%
Devoted_Health-Lex $51 - $55 156%
Ppoplus $51 - $55 156%
Firsthealth-Lex $52 - $56 159%
Multiplan-Lex $52 - $56 159%
Aetna $55 - $60 168%
Phcs-Lex $58 - $63 177%
Molina-Chip-Lex $59 180%
Magnolia-Chip-Lex $60 183%
Truecare-Chip-Lex $60 183%
Molina_Exchange-Lex $65 - $70 199%
United-Lex $65 - $70 199%
United-Options-Lex $65 - $70 199%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 239 Bowling Green Road, Lexington, MS 39095
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - State
  • Hospital Type: Critical Access Hospitals