CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: North Carolina Baptist Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $54
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.65x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at North Carolina Baptist Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.65x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$54

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: $83 (254%)
Insurance Median: $54 (165%)
Cash: $83 (254% of Medicare)
Ins. Median: $54 (165% 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
Aetna $31 - $144 95%
Apex $31 95%
Blue Cross Blue Shield $31 - $57 95%
Cigna $31 - $187 95%
Devoted $31 95%
Healthteam $31 95%
Humana $31 - $93 95%
Medicare (plans) $31 95%
UnitedHealthcare $31 - $59 95%
Wellcare $31 - $39 95%
Medcost $32 - $113 98%
Liberty $35 107%
Amerihealth $36 - $46 110%
Carolina Complete $36 - $38 110%
Health Blue $36 - $38 110%
Partners $36 - $38 110%
Alliance $37 - $39 113%
Trillium $37 - $40 113%
Vaya $37 - $39 113%
Ambetter / Centene $43 - $46 131%
Oscar $48 - $61 147%
Directnet $95 - $100 290%
Cone Health $113 - $119 345%
Healthgram $113 - $119 345%
First Carolina Care $129 - $136 394%
Private Healthcare Systems $132 - $139 403%
Multiplan $145 - $153 443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Medical Center Boulevard, Winston-Salem, NC 27157
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals