CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $304
  • Cash Discount Price: $459
  • vs. Medicare Baseline: 9.29x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at University Medical Center of Princeton at Plainsboro is $304. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 9.29x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$459

Average discount available for prompt cash payment at this facility.

Insurance Median
$304

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: $459 (1402%)
Insurance Median: $304 (929%)
Cash: $459 (1402% of Medicare)
Ins. Median: $304 (929% 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 929% of the Medicare baseline (a markup of 829%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $36 - $382 110%
Blue Cross Blue Shield $36 - $345 110%
Medicare (plans) $36 - $40 110%
Tricare $36 110%
UnitedHealthcare $36 - $158 110%
Us Family Health Plan $36 110%
Va Medical Center $36 110%
Cigna $37 - $459 113%
Clover Health Plan $38 116%
Humana $39 119%
Medicaid / KanCare $42 - $459 128%
Charity Care $43 131%
Wellcare $47 144%
Elap $52 - $65 159%
Horizon Nj Health $60 183%
Centivo $65 199%
Claim Watcher $65 199%
Preferred Health Care Eliance $119 364%
Horizon Behavioral Health $172 526%
Beacon Health Options $230 703%
Amerihealth $272 831%
Princeton Theological Seminary $298 910%
Magnacare $299 - $321 914%
First Managed Care Option $308 - $390 941%
Coventry $321 981%
Health Net $321 981%
Beech Street $367 - $390 1121%
Intergrated Health Plan $367 1121%
Intergroup $367 1121%
Penn Global Medicine Embassy Only $367 1121%
Allied Trades $390 1192%
Consumer Health Network $390 1192%
Devon Health Services $390 1192%
Ie Shaffer $390 1192%
Private Healthcare Systems $390 1192%
Qualcare $390 1192%
Total Care Network $390 1192%
Tri-State $390 1192%
Commercial Other $459 1402%
Compsych $459 1402%
Concern Plus $459 1402%
International Pfs $459 1402%
Life St. Francis $459 1402%
Magellan $459 1402%
Managed Health Network $459 1402%
Nj Carpenters $459 1402%
Penn Behavioral Health Corporate Services $459 1402%
Personnel Health Program $459 1402%
United Behavioral Health $459 1402%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals