CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Jfk University Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $198
  • Cash Discount Price: $41
  • vs. Medicare Baseline: 6.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Jfk University Medical Center is $198. 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 6.05x the Medicare baseline. Located in 65 James Street, Edison, NJ.
Cash / Self-Pay
$41

Average discount available for prompt cash payment at this facility.

Insurance Median
$198

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: $198 (605%)
Cash: $41 (125% of Medicare)
Ins. Median: $198 (605% 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 605% of the Medicare baseline (a markup of 505%). 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 $40 - $210 122%
Amerigroup $41 - $54 125%
Blue Cross Blue Shield $41 - $104 125%
Horizon $41 - $230 125%
Vaccn $41 125%
United Community/Americhoice $43 131%
UnitedHealthcare $43 - $558 131%
Clover $45 137%
Seoul Medical Group $53 162%
Karna $58 177%
Horizon - Jri@Oumc $116 - $205 354%
Cigna $124 - $239 379%
Activecare First McO $174 532%
Intergroup $174 532%
Oxford - Jri@Oumc $193 590%
Prime Health $198 605%
Multiplan - PHCS $211 645%
Wellcare $224 684%
Qualcare $230 - $300 703%
Amerihealth $235 - $245 718%
Bergen Risk $291 889%
Brighton Health Plan $355 - $525 1085%
Oxford $414 - $428 1265%
Brighton Health Plan - Jri@Oumc $500 1528%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 65 James Street, Edison, NJ 08818
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals