CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Caromont Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $44
  • Cash Discount Price: $154
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Caromont Regional Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.34x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.
Cash / Self-Pay
$154

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $154 (471%)
Insurance Median: $44 (134%)
Cash: $154 (471% of Medicare)
Ins. Median: $44 (134% 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
Alliance Behavioral Health $23 - $24 70%
Amerihealth Caritas $23 - $24 70%
Blue Cross Blue Shield $23 - $42 70%
Carolina Complete Health $23 - $24 70%
Carolina Complete Health Tailored Plans $23 - $24 70%
Partners Behavioral Health $23 - $24 70%
UnitedHealthcare $23 - $148 70%
Vaya Behavioral Health $23 - $24 70%
Wellcare $23 - $24 70%
Aetna $33 - $78 101%
Devoted Health $33 101%
Healthteam $33 101%
Longevity Health $33 101%
Molina $33 - $44 101%
Humana $34 - $138 104%
Absolute Total Care $42 - $44 128%
Gaston County Jail $45 - $47 137%
Surgery Plus $55 168%
Cigna $59 - $134 180%
Carolina Caring $79 - $124 241%
Corporate Benefits Service $85 260%
Medcost $102 - $107 312%
Beech Street $123 - $129 376%
Multiplan $123 - $129 376%
Self Pay $135 - $141 412%
First Health Network $142 - $149 434%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2525 Court Dr, Gastonia, NC 28052
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals