CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Penn State Health Hampden Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $36
Cash Discount Price: $63
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Penn State Health Hampden Medical Center is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $63. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$63

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $63 (192%)

Insurance Median: $36 (110%)

Cash: $63 (192% of Medicare)

Ins. Median: $36 (110% 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
[Amerihealth Caritas]	$27 - $32	82%
[Highmark Wholecare]	$27 - $32	82%
[Geisinger]	$28 - $133	86%
[Health Partners Plans]	$29 - $32	89%
[Pa Health & Wellness]	$30 - $33	92%
[Highmark]	$31 - $94	95%
Aetna	$32 - $85	98%
Humana	$32	98%
UnitedHealthcare	$32 - $124	98%
[Cbc]	$32 - $99	98%
[Healthspring]	$32	98%
[Upmc]	$32 - $147	98%
[Point Comfort Underwriters]	$39	119%
[Highmark Choice Blue]	$75	229%
[Highmark Aca]	$79	241%
Cigna	$122	373%
[Preferred Healthcare Systems]	$149	455%
[First Health]	$159	486%
[Multiplan]	$159	486%

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 $63.
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 Penn State Health Hampden 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.