CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Wakemed, Cary Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $60
Cash Discount Price: $49
vs. Medicare Baseline: 1.83x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Wakemed, Cary Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.83x the Medicare baseline. Located in 1900 Kildare Farm Road, Cary, NC.

Cash / Self-Pay

$49

Average discount available for prompt cash payment at this facility.

Insurance Median

$60

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: $49 (150%)

Insurance Median: $60 (183%)

Cash: $49 (150% of Medicare)

Ins. Median: $60 (183% 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	$19	58%
Carolina Complete	$19	58%
Healthy Blue	$19	58%
Wellcare	$19	58%
Blue Cross Blue Shield	$30 - $65	92%
Aetna	$31 - $144	95%
Cary - Alignment	$32	98%
Cary - Liberty	$37	113%
Cary - Pruitt	$37	113%
Cary - Wellcare	$37	113%
Cigna	$38 - $66	116%
Ambetter / Centene	$48 - $49	147%
First Health	$60 - $114	183%
Medcost	$94 - $98	287%
Phcs	$104	318%
Multiplan	$117	357%

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 $49.
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 Wakemed, Cary Hospital 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.