CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Tristar Northcrest Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $33
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Tristar Northcrest Medical Center is $33. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 100 Northcrest Drive, Springfield, TN.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$33

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: $385 (1176%)
Insurance Median: $33 (101%)
Cash: $385 (1176% of Medicare)
Ins. Median: $33 (101% 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.

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
Molina $23 - $31 70%
Alive Hospice $27 - $31 82%
Amerigroup $27 - $31 82%
Devoted Health Plan $27 - $31 82%
Healthspring $27 - $31 82%
Humana $27 - $31 82%
United $27 - $197 82%
Wellcare $27 - $41 82%
Wellpoint $27 - $31 82%
Aetna $28 - $326 86%
Zing $28 - $32 86%
American Health Advantage $29 - $33 89%
Blue Cross Blue Shield $29 - $66 89%
Evergreen Hmo $29 - $33 89%
Atrio Golden Times $30 - $34 92%
Bright Health $32 - $92 98%
Prime Health $39 - $45 119%
Novanet $40 - $46 122%
Oscar $52 - $69 159%
Nhc Advantage, Inc. $63 - $83 192%
Ambetter / Centene $64 - $88 196%
Cigna $84 - $128 257%
City Of Springfield $216 - $285 660%
Multiplan $259 - $359 791%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 Northcrest Drive, Springfield, TN 37172
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals