CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Blount Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $84
Cash Discount Price: $45
vs. Medicare Baseline: 2.57x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Blount Memorial Hospital is $84. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $45. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.57x the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$45

Average discount available for prompt cash payment at this facility.

Insurance Median

$84

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: $45 (137%)

Insurance Median: $84 (257%)

Cash: $45 (137% of Medicare)

Ins. Median: $84 (257% 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 257% of the Medicare baseline (a markup of 157%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$20 - $27	61%
UnitedHealthcare	$22 - $190	67%
Blue Cross Blue Shield	$31 - $135	95%
Humana	$31	95%
Medicare (plans)	$31 - $32	95%
Cigna	$32 - $186	98%
Tricare	$33	101%
Prisma Health Seniorcare Pace - Midlands [5400]	$34	104%
Prisma Health Seniorcare Pace-Upstate [5200]	$34	104%
Ambetter / Centene	$48	147%
Promise Health Plan Contracted [2401]	$51 - $88	156%
Orangeburg Senior Helping Center Pace [5401]	$58	177%
Consociate Health Contracted [4835]	$69	211%
Bob Jones Univ-Pai [821]	$88	269%
Preferred Administrators Contracted [2839]	$102	312%
Medcost [2940]	$108 - $121	330%
Atlantic Packaging Contracted [4833]	$110	336%
Aps Healthcare System [2981]	$117	357%
Multiplan/Phcs Contracted [2950]	$130	397%
Aetna	$131	400%
Meritain Health Contracted [2200]	$131	400%
Nippon [2300]	$131	400%
Vsp Vision Care [2986]	$131	400%
First Health Contracted [2952]	$136	416%
Furman Int/Allen University Student [2951]	$136	416%
Quiktrip-First Health [3067]	$136	416%
Fairos/Occunet Contracted [4837]	$175	535%
Mvp Health Care [3037]	$186	568%
Golden Rule Insurance Company [2991]	$190	581%
Oxford Health Plans [2992]	$190	581%

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 $45.
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 Blount 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.