CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: McKenzie-Willamette Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $95
Cash Discount Price: $161
vs. Medicare Baseline: 2.90x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at McKenzie-Willamette Medical Center is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.90x the Medicare baseline. Located in 1460 G Street, Springfield, OR.

Cash / Self-Pay

$161

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $161 (492%)

Insurance Median: $95 (290%)

Cash: $161 (492% of Medicare)

Ins. Median: $95 (290% 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 290% of the Medicare baseline (a markup of 190%). 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
Pacificsource Hlthier Or	$25	76%
Pacificsource Mcaid	$25	76%
Trillium Mcaid-All Plans	$25	76%
Healthnet Mcd	$28	86%
Kaiser Mcr Adv	$33	101%
Healthnet Mcr Adv	$34	104%
Kaiser Mcaid	$60	183%
Providence Hp Pebb	$65	199%
UnitedHealthcare	$88	269%
Blue Cross Blue Shield	$103	315%
Pacificsource Individual	$134	409%
Healthnet Comm - All Other Plans	$137	419%
Pacificsource Non-Individ	$175	535%
Providence Hp - All Other Plans	$175	535%
Pacificsource Psn/Voyager - All Other Plans	$180	550%
Cigna	$186	568%
Aetna	$215	657%
Kaiser Comm - All Other Plans	$725	2215%

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 $161.
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 McKenzie-Willamette 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.