CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Erlanger Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $46
Cash Discount Price: $132
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Erlanger Medical Center is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $132. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.41x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$132

Average discount available for prompt cash payment at this facility.

Insurance Median

$46

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: $132 (403%)

Insurance Median: $46 (141%)

Cash: $132 (403% of Medicare)

Ins. Median: $46 (141% 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
Bluecare	$19 - $105	58%
Blue Cross Blue Shield	$25 - $200	76%
Aetna	$29 - $122	89%
Humana	$29 - $50	89%
UnitedHealthcare	$29 - $114	89%
Cigna	$32 - $200	98%
Amerigroup	$40 - $97	122%
Alexian	$41 - $44	125%
Caresource	$41 - $82	125%
Clover	$41 - $44	125%
Upmc	$41 - $44	125%
American Health	$42 - $46	128%
Devoted Health	$43 - $46	131%
Nhc	$43 - $46	131%
Medicare (plans)	$44	134%
Atrio Health	$45 - $49	137%
Pruitthealth Premier	$45	137%
Simpra Advantage	$49	150%
Ambetter / Centene	$52 - $55	159%
Caresource Ga	$62 - $110	189%
Caresource Tn	$62 - $110	189%
Olympus	$66 - $188	202%
Alliant	$71 - $188	217%
Pnoa	$71 - $103	217%
Caresource Nc	$74 - $110	226%
Occunet	$77	235%
Point Comfort Underwriters	$78 - $80	238%
Wellpoint	$100	306%
First Health	$200 - $212	611%

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 $132.
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 Erlanger 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.