CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Tristar Southern Hills Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $32
Cash Discount Price: $547
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Tristar Southern Hills Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $547. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 391 Wallace Rd, Nashville, TN.

Cash / Self-Pay

$547

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: $547 (1671%)

Insurance Median: $32 (98%)

Cash: $547 (1671% 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.

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
Wellpoint	$20 - $22	61%
Blue Cross Blue Shield	$26 - $66	79%
Amerigroup	$27 - $31	82%
Devoted Health Plan	$27 - $31	82%
Healthspring	$27 - $31	82%
Humana	$27 - $137	82%
Odyssey Healthcare	$27 - $31	82%
Sarah Cannon Research	$27 - $31	82%
United	$27 - $246	82%
Aetna	$28 - $326	86%
Wellcare	$28 - $32	86%
Zing	$28 - $32	86%
American Health Advantage	$29 - $33	89%
Evergreen Hmo	$29 - $33	89%
Signature Advantage	$29 - $33	89%
Atrio Golden Times	$30 - $34	92%
Bright Health	$32 - $131	98%
Prime Health	$39 - $481	119%
Corvel Corporation	$40 - $46	122%
Novanet	$40 - $46	122%
Oscar	$100	306%
Kentucky Labor Cabinet	$101	309%
Apex Health	$104	318%
Nhc Advantage, Inc.	$104	318%
Pruitt Health (Allyalign)	$104	318%
Ambetter / Centene	$122 - $127	373%
Cigna	$138 - $178	422%
Bgfh Singlesource	$273 - $465	834%
Multiplan	$317	969%
Employers Health Network	$383	1170%
Odom'S Tn Pride Sausage	$410	1253%
Beech Street	$481	1470%

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 $547.
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 Tristar Southern Hills 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.