CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Pawhuska Hospital, Inc

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $47
Cash Discount Price: $39
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Pawhuska Hospital, Inc is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $39. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.44x the Medicare baseline. Located in 1101 East 15Th Street, Pawhuska, OK.

Cash / Self-Pay

$39

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $39 (119%)

Insurance Median: $47 (144%)

Cash: $39 (119% of Medicare)

Ins. Median: $47 (144% 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
Blue Cross Blue Shield	$28 - $68	86%
Aetna	$31 - $80	95%
Tricare	$31 - $46	95%
UnitedHealthcare	$31 - $263	95%
Wellcare Mcr Adv - All Plans	$31 - $46	95%
Humana	$32 - $80	98%
Healthcare Highways - All Plans	$35 - $52	107%
Cigna	$37 - $54	113%
Multiplan - All Plans	$40 - $60	122%
Ambetter / Centene	$47 - $70	144%
Preferred Commchoice Ip/Op Only - All Plans	$49 - $72	150%
Soonerselect Mcaid - All Plans	$54 - $80	165%
Healthchoice Ip/Op Only - All Plans	$58	177%
Community Care Comm - All Plans	$77	235%

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 $39.
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 Pawhuska Hospital, Inc 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.