CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: High Point Regional Health System

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $59
Cash Discount Price: $70
vs. Medicare Baseline: 1.80x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at High Point Regional Health System is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.80x the Medicare baseline. Located in 601 N Elm St, High Point, NC.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $70 (214%)

Insurance Median: $59 (180%)

Cash: $70 (214% of Medicare)

Ins. Median: $59 (180% 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
Amerihealth	$20 - $45	61%
Carolina Complete	$20	61%
Healthy Blue	$20	61%
Partners	$20	61%
UnitedHealthcare	$20 - $268	61%
Vaya	$20	61%
Wellcare	$20	61%
Alliance	$21	64%
Trillium	$21	64%
Medcost	$37 - $89	113%
Aetna	$41 - $90	125%
Oscar	$42 - $56	128%
Ambetter / Centene	$44	134%
Blue Cross Blue Shield	$44 - $70	134%
Cigna	$76	232%
Directnet	$82	251%
Private Healthcare Systems	$114	348%
Multiplan	$125	382%
Humana	$129 - $132	394%

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 $70.
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 High Point Regional Health System 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.