CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Howard County Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $176
Cash Discount Price: $258
vs. Medicare Baseline: 5.38x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Howard County Medical Center is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $258. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.38x the Medicare baseline. Located in P O Box 406, 1113 Sherman St, St Paul, NE.

Cash / Self-Pay

$258

Average discount available for prompt cash payment at this facility.

Insurance Median

$176

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: $258 (788%)

Insurance Median: $176 (538%)

Cash: $258 (788% of Medicare)

Ins. Median: $176 (538% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 538% of the Medicare baseline (a markup of 438%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$26	79%
Aetna	$31 - $391	95%
Blue Cross Blue Shield	$31 - $391	95%
Great Plains	$31 - $235	95%
Medica Chi	$31 - $235	95%
Medica Elevate	$31 - $62	95%
Medica Standard Premier	$31	95%
Nebraska Total Care - Wellcare	$31	95%
Tricare	$31 - $309	95%
UnitedHealthcare	$31 - $396	95%
Molina Healthcare	$32 - $206	98%
Ambetter / Centene	$46	141%
Nebraska Total Care	$52 - $206	159%
Oscar Health	$53	162%
Beshp	$61	186%
Midland'S Choice	$65	199%
Medica Chi Aco	$94 - $375	287%
Medica Choice National	$94 - $375	287%
Medica Ifb Aco	$99 - $396	302%
Medica Ifb Open Access	$99 - $396	302%

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 $258.
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 Howard County Medical Center 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.