CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Tristar Summit Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $32
  • Cash Discount Price: $173
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Tristar Summit Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 5655 Frist Blvd, Hermitage, TN.
Cash / Self-Pay
$173

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $173 (529%)
Insurance Median: $32 (98%)
Cash: $173 (529% of Medicare)
Ins. Median: $32 (98% 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
Blue Cross Blue Shield $23 - $66 70%
Wellpoint $25 - $28 76%
Amerigroup $27 - $31 82%
Devoted Health Plan $27 - $31 82%
Healthspring $27 - $31 82%
Humana $27 - $112 82%
Odyssey Healthcare $27 - $31 82%
Sarah Cannon Research $27 - $31 82%
United $27 - $78 82%
Aetna $28 - $326 86%
Wellcare $28 - $32 86%
Zing $28 - $32 86%
American Health Advantage $29 - $33 89%
Bright Health $29 - $42 89%
Evergreen Hmo $29 - $33 89%
Signature Advantage $29 - $33 89%
Atrio Golden Times $30 - $34 92%
Kentucky Labor Cabinet $32 98%
Oscar $32 98%
Apex Health $33 101%
Nhc Advantage, Inc. $33 101%
Pruitt Health (Allyalign) $33 101%
Ambetter / Centene $39 - $40 119%
Prime Health $39 - $152 119%
Corvel Corporation $40 - $46 122%
Novanet $40 - $46 122%
Cigna $44 - $138 134%
Bgfh Singlesource $86 - $147 263%
Multiplan $112 342%
Employers Health Network $121 370%
Odom'S Tn Pride Sausage $130 397%
Compsych $138 422%
Beech Street $152 464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5655 Frist Blvd, Hermitage, TN 37076
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals