CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Atlanticare Regional Medical Center - City Campus

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $153
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 4.67x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Atlanticare Regional Medical Center - City Campus is $153. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.67x the Medicare baseline. Located in 1925 Pacific Avenue, Atlantic City, NJ.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$153

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%)
Insurance Median: $153 (467%)
Ins. Median: $153 (467% 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 467% of the Medicare baseline (a markup of 367%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Americhoice $23 - $30 70%
UnitedHealthcare $23 - $168 70%
Horizon $24 - $165 73%
Wellcare $24 - $33 73%
Self Pay $26 - $35 79%
Devoted Health Plan $43 131%
Amerigroup $46 - $61 141%
Global Exchange Managed Care $63 192%
Magnacare $70 - $212 214%
Cigna $73 - $119 223%
Health Partners Plan $84 257%
Aetna $85 - $177 260%
Evernorth $88 - $118 269%
Great West Life $88 - $119 269%
Qualcare Commercial $88 - $118 269%
Amerihealth $113 - $198 345%
Active Care Plus $114 - $153 348%
First Mco $114 - $153 348%
Mutual Of Omaha $114 - $153 348%
Qualcare Wc $114 - $153 348%
Consumer Health Network (Chn) $122 - $212 373%
Donio Trucking $122 - $165 373%
Devon/ Ullicare $131 - $177 400%
Oxford $131 - $177 400%
Coventry Health Care $140 - $189 428%
Private Healthcare System (Phcs) $140 - $189 428%
Blue Cross Blue Shield $144 - $194 440%
Health Payors Org $149 - $201 455%
Health South $149 - $201 455%
Metrahealth Of Nj $149 - $201 455%
Prime Health Services $149 - $201 455%
Three Rivers Provider Network (Trpn) $149 - $201 455%
Active Care Nj Pip $158 - $212 483%
Beech Street $158 - $212 483%
Choice Care $158 - $212 483%
Department Of Corrections $158 - $212 483%
Galaxy Health Network $158 - $212 483%
Health Network Inc $158 - $212 483%
Intergroup Preferred Program $158 - $212 483%
Mcs Commercial $158 - $212 483%
Metracomp $158 - $212 483%
Multiplan $158 - $212 483%
Provider Select, Inc $158 - $212 483%
Atlantis Health Plan $162 - $218 495%
Master Care Inc $162 - $218 495%
Advance Healthcare System $166 - $224 507%
Community Care Network $166 - $224 507%
Health Network America $166 - $224 507%
Mcsi/Mrsi No Fault $166 - $224 507%
Mcsi/Mrsi Worker'S Comp $166 - $224 507%
National Health Plan $166 - $224 507%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1925 Pacific Avenue, Atlantic City, NJ 08401
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals