CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Hackensack University Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $211
Cash Discount Price: $41
vs. Medicare Baseline: 6.45x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Hackensack University Medical Center is $211. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $41. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 6.45x the Medicare baseline. Located in 30 Prospect Ave, Hackensack, NJ.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$211

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: $41 (125%)

Insurance Median: $211 (645%)

Cash: $41 (125% of Medicare)

Ins. Median: $211 (645% 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 645% of the Medicare baseline (a markup of 545%). 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
UnitedHealthcare	$33 - $406	101%
Aetna	$41 - $383	125%
Amerigroup	$41	125%
Blue Cross Blue Shield	$41	125%
Horizon	$41 - $242	125%
Vaccn	$41	125%
Wellcare	$41	125%
United Community/Americhoice	$43	131%
Clover	$45	137%
Karna	$58	177%
Seoul Medical Group	$71	217%
Intergroup	$174	532%
Lhp Health	$196	599%
Cigna	$198 - $238	605%
Activecare First McO	$211	645%
Chn	$211	645%
Multiplan - PHCS	$211	645%
Qualcare	$219	669%
Brighton Health Plan	$223	681%
Amerihealth	$248	758%
Bergen Risk	$291	889%
Oxford	$346	1057%

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 $41.
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 Hackensack University 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.