CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Albany Medical Center Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $49
  • Cash Discount Price: $83
  • vs. Medicare Baseline: 1.50x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Albany Medical Center Hospital is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.50x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$83

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

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: $83 (254%)
Insurance Median: $49 (150%)
Cash: $83 (254% of Medicare)
Ins. Median: $49 (150% 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.

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 $10 - $260 31%
UnitedHealthcare $16 - $178 49%
Cdphp $21 - $214 64%
Medicare (plans) $23 - $34 70%
Fidelis $25 - $214 76%
Blue Cross Blue Shield $26 - $214 79%
Tricare $26 - $31 79%
Nascentia Health Options $27 - $122 82%
Blue Shield Highmark $28 - $70 86%
Emblem $29 - $269 89%
Hamaspik $29 - $223 89%
Mvp $32 - $95 98%
Nascentia $34 104%
Blue Shield $35 - $283 107%
Emblem Health Ghi $35 - $68 107%
Empire Plan Nyship $39 - $178 119%
Magnacare $39 - $178 119%
Multiplan $41 - $189 125%
Cigna $49 - $60 150%
Mvp Commercial $77 - $296 235%
Nys Department Of Corrections $77 235%
Emblem_Ghi $82 - $358 251%
Mvp Essential Plan $204 623%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals