CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Prisma Health Greer Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $50
Cash Discount Price: $109
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Prisma Health Greer Memorial Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $109. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.53x the Medicare baseline. Located in 1413 John B White Sr Blvd Suite D, Spartanburg, SC.

Cash / Self-Pay

$109

Average discount available for prompt cash payment at this facility.

Insurance Median

$50

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: $109 (333%)

Insurance Median: $50 (153%)

Cash: $109 (333% of Medicare)

Ins. Median: $50 (153% 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
Blue Choice Healthplan Of Sc	$20 - $37	61%
Medicaid / KanCare	$21 - $40	64%
Bluechoice Healthplan Of Sc	$22 - $128	67%
Humana	$23 - $41	70%
Molina	$23 - $39	70%
Select Health	$23 - $39	70%
Tricare	$30 - $32	92%
Medicare (plans)	$32 - $50	98%
Veterans Administration	$32	98%
Blue Cross Blue Shield	$33 - $122	101%
Choicecare Network	$33 - $142	101%
Cigna	$33 - $174	101%
Liberty Advantage	$33	101%
UnitedHealthcare	$33 - $34	101%
Absolute Total Care Prime	$34	104%
Aetna	$34 - $147	104%
Windsor Health Plan	$34	104%
Prisma Health Seniorcare Pace-Upstate	$40	122%
Wellpath Select Inc	$44	134%
Sc Workers Compensation	$45	137%
Celtic Insurance Company	$56	171%
Value Options	$84	257%
Promise Health Plan	$100	306%
Preferred Care, Inc	$117	357%
Chp Direct Supermed Network	$120	367%
Medcost	$124	379%
Atlantic Packaging	$125	382%
Aps Healthcare Bethesda Inc	$134	409%
Medcost Preferred	$137	419%
Multiplan	$149	455%
Companion Benefit Alternatives	$167	510%
Miscellaneous	$167	510%
Self Pay	$167	510%

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 $109.
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 Prisma Health Greer Memorial Hospital 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.