CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $79
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.41x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Intermountain Health St Vincent Regional Hospital is $79. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.41x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$79

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%)

Insurance Median: $79 (241%)

Ins. Median: $79 (241% 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 241% of the Medicare baseline (a markup of 141%). 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
Medicare (plans)	$36	110%
UnitedHealthcare	$37 - $91	113%
First Choice Health	$53 - $88	162%
Other	$53 - $88	162%
Ebms-Employee Benefit Mng	$60 - $86	183%
Exchange Other	$60 - $65	183%
Mt Health Co-Op	$60 - $65	183%
Meritain Health	$61 - $74	186%
Aetna	$63	192%
Allegiance	$68 - $99	208%
Cigna	$68 - $89	208%
Sibanye Stillwater Health Partners	$68	208%
Coastal Administrative Services	$72	220%
Blue Cross Blue Shield	$74 - $102	226%
Preferred One	$85 - $92	260%
Interwest	$89	272%
Pacificsource	$89 - $90	272%
Pacific Steel And Recycling	$90	275%
Private Hlthcare Sys	$90	275%
Geha	$91	278%

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 $X.
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 Intermountain Health St Vincent Regional 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.