CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Flushing Hospital Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $38
Cash Discount Price: $80
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Flushing Hospital Medical Center is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.16x the Medicare baseline. Located in 45Th Avenue and Parsons Boulevard, Flushing, NY.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $80 (244%)

Insurance Median: $38 (116%)

Cash: $80 (244% of Medicare)

Ins. Median: $38 (116% 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.

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
UnitedHealthcare	$24 - $202	73%
Ghi	$27 - $37	82%
Healthfirst	$31	95%
Fidelis	$35 - $37	107%
Aetna	$37	113%
Beacon Health Strategies	$37	113%
Centerlight Healthcare	$37	113%
Empire	$37 - $69	113%
Hip	$37 - $72	113%
Humana	$37 - $39	113%
Metroplus	$37 - $40	113%
Elderplan	$38	116%
Vns	$38	116%
Wellcare Of Ny	$38	116%
Senior Whole Health	$39	119%
Elderserve Health	$42	128%
Hamaspik Choice	$42	128%
Magnacare	$42	128%
Centers Plan For Healthy Living	$44	134%
1199 National Benefit Fund	$50	153%
Emblemhealth	$57	174%
Empire Blue Priority	$59	180%
Hotel Trades Council	$68 - $1,912	208%
Cigna	$264	807%

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 $80.
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 Flushing Hospital 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.