CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Memorial Mission Hospital and Asheville Surgery Ce

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $33
Cash Discount Price: $140
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Memorial Mission Hospital and Asheville Surgery Ce is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 509 Biltmore Ave, Asheville, NC.

Cash / Self-Pay

$140

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: $140 (428%)

Insurance Median: $33 (101%)

Cash: $140 (428% 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
Blue Cross Blue Shield	$26	79%
United	$26 - $82	79%
Wellcare	$26 - $33	79%
Amerihealth	$27	82%
Partners Health Management	$27	82%
Vaya Health	$27	82%
Aetna	$28 - $101	86%
Alignment Health	$28 - $32	86%
Apex Health	$28	86%
United Behavioral Health	$28 - $32	86%
Humana	$29 - $33	89%
Provider Partners Health Plan	$29 - $33	89%
Pruitthealth Premier	$29 - $33	89%
Cigna	$30 - $70	92%
Troy Healthcare	$30 - $34	92%
Healthteam Advantage	$31 - $35	95%
Amerihealth Caritas	$32 - $66	98%
Longevity Health Plan	$33 - $38	101%
Oscar	$50	153%
Caresource	$61	186%
Medcost	$79 - $119	241%
Magellan	$84	257%
Magellan Behavioral Health	$84	257%
Multiplan	$112	342%
Avalon Administrative Services	$119	364%
Prime Health	$123 - $126	376%

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 $140.
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 Memorial Mission Hospital and Asheville Surgery Ce 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.