CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Bellevue Hospital Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $119
Cash Discount Price: $42
vs. Medicare Baseline: 3.64x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Bellevue Hospital Center is $119. 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 3.64x the Medicare baseline. Located in 462 First Avenue, New York, NY.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $119 (364%)

Cash: $42 (128% of Medicare)

Ins. Median: $119 (364% 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 364% of the Medicare baseline (a markup of 264%). 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
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 - $41	110%
Elderplan	$36 - $221	110%
Fidelis	$36 - $267	110%
Wellcare	$36 - $46	110%
Centers Plan For Healthy Living	$37	113%
Hamaspik	$38 - $41	116%
Oxford	$43 - $410	131%
Oscar	$45 - $614	137%
Metroplus	$48 - $267	147%
Amidacare	$119	364%
Carelon	$119 - $221	364%
Senior Whole Health	$119	364%
United	$119 - $504	364%
United Behavioral Health	$119 - $130	364%
Carelon (Amida Care)	$121	370%
Vnsny	$121 - $289	370%
Emblem	$178 - $319	544%
Villagecare Max	$209 - $289	639%
Cigna	$241	736%
Magnacare	$255 - $320	779%
Multiplan	$272	831%

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 $42.
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 Bellevue Hospital 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.