CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Manati Medical Center Dr Otero Lopez

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $21
Cash Discount Price: $11
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Manati Medical Center Dr Otero Lopez is $21. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.64x the Medicare baseline. Located in Carr 668 Calle Hernandez Carrion Urb Atenas, Manati, PR.

Cash / Self-Pay

$11

Average discount available for prompt cash payment at this facility.

Insurance Median

$21

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: $11 (34%)

Insurance Median: $21 (64%)

Cash: $11 (34% of Medicare)

Ins. Median: $21 (64% 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
Acaa	$10	31%
Plan Vital	$11 - $21	34%
Triple S Com	$11	34%
McS Classicare	$20	61%
Medical Card System	$20	61%
Prossam	$23	70%
Mmm	$31	95%
Palic	$31	95%
Medicare (plans)	$36	110%
Triple S	$36	110%

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 $11.
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 Manati Medical Center Dr Otero Lopez 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.