CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: St Jude Childrens Research Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $68
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at St Jude Childrens Research Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.08x the Medicare baseline. Located in 262 Danny Thomas Place, Memphis, TN.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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%)

Insurance Median: $68 (208%)

Ins. Median: $68 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
Blue Cross Blue Shield	$16 - $103	49%
Healthcare Connections La	$16	49%
Tenncare Select Hmo	$18	55%
UnitedHealthcare	$20 - $110	61%
Healthy Blue	$26	79%
Home State Health	$29 - $76	89%
Medicaid / KanCare	$31	95%
Molina Marketplace Of Ms	$45	137%
Health Choice - Ok	$61	186%
Vantage	$61 - $68	186%
Humana	$66	202%
Tricare	$71	217%
Aetna	$76	232%
Private Health Care Systems	$82	251%
Ms Physicians Care Network	$87	266%
Baptist Health	$92	281%
First Health Ccn	$92	281%
Health Choice	$92	281%
Health Link Mississippi	$92	281%
Healthscope Benefits Inc	$92	281%
Cigna	$160	489%

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 $X.
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 St Jude Childrens Research 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.