CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ocean Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $171
Cash Discount Price: $41
vs. Medicare Baseline: 5.22x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ocean Medical Center is $171. 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 5.22x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$41

Average discount available for prompt cash payment at this facility.

Insurance Median

$171

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: $171 (522%)

Cash: $41 (125% of Medicare)

Ins. Median: $171 (522% 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 522% of the Medicare baseline (a markup of 422%). 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
Aetna	$28 - $210	86%
Clover	$36 - $45	110%
Seoul Medical Group	$39 - $53	119%
Amerigroup	$41 - $54	125%
Horizon	$41 - $188	125%
Vaccn	$41	125%
United Community/Americhoice	$43	131%
UnitedHealthcare	$49 - $558	150%
Karna	$56 - $58	171%
Blue Cross Blue Shield	$104	318%
Horizon - Jri@Oumc	$116 - $205	354%
Cigna	$124 - $239	379%
Qualcare	$155 - $306	474%
Activecare First McO	$170 - $174	519%
Multiplan - PHCS	$170 - $211	519%
Amerihealth	$172 - $245	526%
Intergroup	$174	532%
Oxford - Jri@Oumc	$193	590%
Prime Health	$198	605%
Wellcare	$224	684%
Bergen Risk	$291	889%
Brighton Health Plan	$355 - $525	1085%
Oxford	$414 - $495	1265%
Brighton Health Plan - Jri@Oumc	$500	1528%

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 Ocean 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.