CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $183
  • Cash Discount Price: $482
  • vs. Medicare Baseline: 5.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Hospital of Univ of Pennsylvania is $183. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.59x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$482

Average discount available for prompt cash payment at this facility.

Insurance Median
$183

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: $482 (1473%)
Insurance Median: $183 (559%)
Cash: $482 (1473% of Medicare)
Ins. Median: $183 (559% 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 559% of the Medicare baseline (a markup of 459%). 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
Gspp And Wissahickon Hospice $17 52%
Health Partners $23 - $482 70%
UnitedHealthcare $29 - $482 89%
Blue Cross Blue Shield $33 - $299 101%
Kaiser Permanente $33 - $482 101%
Medicare (plans) $33 - $34 101%
Philadelphia Va Medical Center $33 101%
Tricare $33 101%
Upmc $33 - $482 101%
Us Family Health Plan $33 101%
Cigna $34 - $217 104%
Geisinger Health Plan $34 - $106 104%
Humana $34 - $386 104%
Ibc $34 104%
Aetna $35 - $482 107%
Devoted Health $35 107%
Pa Health And Wellness $35 - $55 107%
Penn Life (Living Independently For Elders) $35 107%
Clover Health Plan $36 110%
Keystone First $37 113%
Gateway Health Plan $41 125%
Elap $47 144%
Claims Watcher $53 - $60 162%
Oscar Health Plan $57 174%
Centivo $60 183%
Elap Services $62 189%
Highmark $70 214%
Paired Kidney Exchange $77 235%
Horizon Nj Health $81 - $85 247%
Penn Global Medicine $88 269%
Keystone Mercy Health Plan $96 - $482 293%
Preferred Health Care Eliance $106 324%
Pgm - Regie De L'Assurance Maladie Quebec $111 339%
Ibc Commercial Hpn $123 376%
Keystone Hmo Proactive $126 385%
Pgm - Kuwait Defense $169 - $217 516%
Qualcare $183 559%
Olympus $189 577%
Coventry $193 - $246 590%
Medicaid / KanCare $193 - $482 590%
Pgm - Chop $193 590%
Wissahickon Hospice $193 590%
Healthamerica/Coventry $217 - $236 663%
First Health Global $241 736%
Health Net $289 883%
Pgm - Royal Embassy Of Saudi Arabia $289 883%
Pgm - Embassy Of Qatar $313 956%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $313 956%
Interlink $323 987%
Pgm - Embassy Of The United Emirates/Ipc $337 1030%
Health America/Ccn $386 1179%
Intergroup $386 1179%
Pgm - Kuwait Health Division $386 1179%
Pgm - Kuwait Oil $386 1179%
Preferred Care $386 1179%
Blue Quality Centers For Transplant (Bqct) $482 1473%
City Of Philadelphia Behavioral Health $482 1473%
Commercial Other $482 1473%
International Pfs $482 1473%
Pa Medical Assistance $482 1473%
United Behavioral Health $482 1473%
Workers Compensation $482 1473%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals