CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Ohiohealth Morrow County Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $85
Cash Discount Price: $65
vs. Medicare Baseline: 2.60x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Ohiohealth Morrow County Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $65. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.60x the Medicare baseline. Located in 651 West Marion Road, Mount Gilead, OH.

Cash / Self-Pay

$65

Average discount available for prompt cash payment at this facility.

Insurance Median

$85

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: $65 (199%)

Insurance Median: $85 (260%)

Cash: $65 (199% of Medicare)

Ins. Median: $85 (260% 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 260% of the Medicare baseline (a markup of 160%). 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
Blue Cross Blue Shield	$37 - $106	113%
Medicare (plans)	$37 - $38	113%
UnitedHealthcare	$37 - $105	113%
Aetna	$38 - $86	116%
Humana	$38 - $108	116%
Caresource Marketplace - All Other Plans	$46	141%
Medical Mutual Of Ohio Marketplace	$75	229%
Ohiohealthy Network - All Other Plans	$75	229%
Ohiohealthy Preferred	$75	229%
Medical Mutual Of Ohio Comm - All Other Plans	$81	247%
Medical Mutual Of Ohio - Admin Serv	$85	260%
Phcs - All Plans	$92	281%
Cigna	$94	287%
Multiplan - All Plans	$95	290%
Healthstar Comm - All Plans	$96	293%
Beech Street - All Plans	$97	296%
Medicaid / KanCare	$105 - $107	321%
Amerihealth Caritas - All Plans	$108	330%
Molina Exchange - All Other Plans	$172	526%

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 $65.
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 Ohiohealth Morrow County Hospital 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.