CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Arnot Ogden Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $86
Cash Discount Price: $124
vs. Medicare Baseline: 2.63x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Arnot Ogden Medical Center is $86. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $124. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.63x the Medicare baseline. Located in 600 Roe Avenue, Elmira, NY.

Cash / Self-Pay

$124

Average discount available for prompt cash payment at this facility.

Insurance Median

$86

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: $124 (379%)

Insurance Median: $86 (263%)

Cash: $124 (379% of Medicare)

Ins. Median: $86 (263% 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 263% of the Medicare baseline (a markup of 163%). 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
Empire	$16	49%
Aetna	$26 - $119	79%
Blue Cross Blue Shield	$26 - $481	79%
Amerihealth Mcr Adv - All Plans	$32	98%
Humana	$32 - $143	98%
Tricare	$32	98%
Geisinger	$43 - $78	131%
Fidelis	$46 - $78	141%
Fidelis Care-Exchange - All Plans	$68 - $87	208%
Geisinger - All Plans	$72 - $92	220%
Cigna	$77 - $99	235%
Mvp Health Plan - All Plans	$77 - $99	235%
Icircle	$78	238%
UnitedHealthcare	$78 - $109	238%
Independent Health - All Plans	$81 - $103	247%
Upmc Health Plan - All Plans	$86 - $109	263%
Pomco Inc - All Plans	$89 - $114	272%
Emblem Health - All Plans	$109 - $139	333%
Emblem/Ghi	$115	351%
Martins Point Mcr Adv - All Plans	$124 - $159	379%
Healthnow - All Plans	$374 - $478	1143%

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 $124.
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 Arnot Ogden 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.