CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Carolina East Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $66
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Carolina East Medical Center is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $66. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.
Cash / Self-Pay
$66

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $66 (202%)
Insurance Median: $63 (192%)
Cash: $66 (202% of Medicare)
Ins. Median: $63 (192% 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
Pamlico Co Jail-All Plans $19 - $40 58%
UnitedHealthcare $24 - $106 73%
Humana $32 98%
Inclusive Health (Nchirp)-All Plans $32 98%
Tricare $32 - $149 98%
Medcost Ppo Employees And Retirees $46 - $98 141%
Medcost Ppo Ultra (Employees) $46 - $93 141%
Craven Co. Jail Systems - All Plans $47 - $50 144%
Blue Cross Blue Shield $49 - $102 150%
Medcost Ppo City Employees $51 - $109 156%
Medcost Ppo County Employee $53 - $113 162%
Benefit Mgmt, Svcs-All Plans $60 - $127 183%
Aetna $62 - $132 189%
Medcost Benefit Svc-All Other Plans $62 - $132 189%
Acs Consult Svc Inc-All Plans $63 - $135 192%
Medcost Ppo Standard $63 - $135 192%
Cigna $64 - $136 196%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2000 Neuse Blvd, New Bern, NC 28560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals