CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Portsmouth Regional Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $52
  • Cash Discount Price: $245
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Portsmouth Regional Hospital is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $245. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.59x the Medicare baseline. Located in 333 Borthwick Ave, Portsmouth, NH.
Cash / Self-Pay
$245

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $245 (749%)
Insurance Median: $52 (159%)
Cash: $245 (749% of Medicare)
Ins. Median: $52 (159% 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
Amerihealth Caritas $10 31%
Well Sense Health Plan $20 61%
Aetna $29 - $155 89%
Humana $29 - $33 89%
United Behavioral Health $29 - $33 89%
United Va Ccn $29 - $33 89%
Blue Cross Blue Shield $30 - $109 92%
Cigna $30 - $34 92%
Evernorth Behavioral Health $30 - $34 92%
Martin'S Point Health $30 - $35 92%
United $30 - $162 92%
Sierra Military Health $33 101%
Ambetter / Centene $52 - $59 159%
Maine Community Health $77 - $130 235%
Tufts Health Plan $92 - $140 281%
Harvard Pilgrim $105 321%
Corvel $176 538%
Evernorth $196 599%
Mutual Of Omaha $196 599%
Multiplan $198 605%
First Health $223 681%
Healthcare Value Mgmt $223 681%
Oxford Health Plans $233 712%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 333 Borthwick Ave, Portsmouth, NH 03801
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals