CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Kings County Hospital Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $121
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 3.70x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Kings County Hospital Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.70x the Medicare baseline. Located in 451 Clarkson Avenue, Brooklyn, NY.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $42 (128%)
Insurance Median: $121 (370%)
Cash: $42 (128% of Medicare)
Ins. Median: $121 (370% 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 370% of the Medicare baseline (a markup of 270%). 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
Healthfirst $18 - $267 55%
Aetna $20 - $257 61%
Affinity $32 - $267 98%
Local 1199 $33 - $289 101%
Blue Cross Blue Shield $36 - $272 110%
Centerlight $36 - $170 110%
Elderplan $36 - $221 110%
Fidelis $36 - $267 110%
Wellcare $37 - $39 113%
Centers Plan For Healthy Living $38 116%
Hamaspik $38 116%
Oscar $46 - $614 141%
Metroplus $111 - $267 339%
Amidacare $119 364%
Carelon $119 - $221 364%
Senior Whole Health $119 364%
United $119 - $504 364%
United Behavioral Health $119 - $131 364%
Carelon (Amida Care) $121 370%
Vnsny $121 - $289 370%
Emblem $178 - $319 544%
Villagecare Max $209 - $289 639%
Oxford $236 - $410 721%
Cigna $241 736%
Magnacare $255 - $320 779%
Multiplan $272 831%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 451 Clarkson Avenue, Brooklyn, NY 11203
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals