CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $91
Cash Discount Price: $65
vs. Medicare Baseline: 2.78x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Mary Hitchcock Memorial Hospital is $91. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.78x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$91

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: $65 (199%)

Insurance Median: $91 (278%)

Cash: $65 (199% of Medicare)

Ins. Median: $91 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Amerihealth Caritas Nh	$24 - $26	73%
Harvard Pilgrim Health Care of Ne	$24 - $136	73%
Beacon Health Strategies/Carelon	$25 - $26	76%
Granite State Health Plan	$25 - $27	76%
Wellsense Health Plan	$25 - $34	76%
UnitedHealthcare	$30 - $163	92%
Aetna	$33 - $149	101%
Blue Cross Blue Shield	$33 - $202	101%
Cigna	$33 - $145	101%
Martin's Point Generations Advantage	$33	101%
Mvp	$33 - $142	101%
Ambetter / Centene	$34 - $107	104%
Martin's Point Health Care	$34 - $73	104%
Wellcare Health Plans	$34	104%
Mass General Brigham Health Plan	$97 - $132	296%
Tufts Health Plan	$110 - $139	336%
Maine Community Health Options	$135 - $156	412%
Coventry	$184	562%
First Health/Hcvm	$184	562%
PHCS	$191	584%
Corvel	$195	596%
Ccmsi	$201	614%

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 $65.
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 Mary Hitchcock Memorial 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.