CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Chester County Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $85
  • Cash Discount Price: $238
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Chester County Hospital is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.60x the Medicare baseline. Located in 701 East Marshall Street, West Chester, PA.
Cash / Self-Pay
$238

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: $238 (727%)
Insurance Median: $85 (260%)
Cash: $238 (727% 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.

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
Health Partners $23 - $238 70%
UnitedHealthcare $24 - $157 73%
Tricare $33 101%
Us Family Health Plan $33 101%
Hospice Vna $34 104%
Medicare (plans) $34 104%
Primecare Medical $34 104%
Va Medical Center $34 104%
Cigna $35 - $238 107%
Devoted Health $35 107%
Humana $35 107%
Pa Health And Wellness $35 - $56 107%
Aetna $36 - $80 110%
Clover Health Plan $36 110%
Keystone First Vip Choice $37 113%
Mva Insurance $37 113%
Gateway $42 128%
Elap $48 147%
Keystone First $48 147%
Claims Watcher $54 - $61 165%
Pgm - Regie De L'Assurance Maladie Quebec $55 168%
Oscar Health Plan $57 174%
Medicaid / KanCare $60 - $238 183%
Centivo $61 186%
Elap Services $63 192%
Todays Option $67 205%
Highmark $69 211%
Preferred Health Care Eliance $74 226%
Pgm - Kuwait Defense $83 - $107 254%
Ibc $85 - $95 260%
Keystone Hmo Proactive $85 260%
Penn Global Medicine $89 272%
Qualcare $90 275%
Pgm - Chop $95 290%
Geisinger Health Plan $107 327%
Medrisk $130 - $238 397%
Pgm - Royal Embassy Of Saudi Arabia $143 437%
Pgm - Embassy Of Qatar $155 474%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $155 474%
Pgm - Embassy Of The United Emirates/Ipc $167 510%
Healthamerica/Coventry $178 544%
Pgm - Kuwait Health Division $190 581%
Pgm - Kuwait Oil $190 581%
Preferred Health Care $190 581%
Intergroup $202 617%
Olympus $208 636%
International Pfs $238 727%
La Comunidad Hispana $238 727%
Not Adjusted $238 727%
Workers Compensation $238 727%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 East Marshall Street, West Chester, PA 19380
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals