CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Medical Center Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $61
Cash Discount Price: $79
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Medical Center Hospital is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.86x the Medicare baseline. Located in 500 W 4Th Street, Odessa, TX.

Cash / Self-Pay

$79

Average discount available for prompt cash payment at this facility.

Insurance Median

$61

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: $79 (241%)

Insurance Median: $61 (186%)

Cash: $79 (241% of Medicare)

Ins. Median: $61 (186% 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
Corvel Wc	$16	49%
Medicaid / KanCare	$17 - $18	52%
Superior Chips	$17	52%
UnitedHealthcare	$19 - $160	58%
Aetna	$31 - $82	95%
Humana	$31	95%
Novitas Solutions	$31	95%
Triwest Va Ccn	$31	95%
Care Improvement Plus	$32	98%
Ambetter / Centene	$33	101%
Wellcare By Allwell	$33	101%
Group Resources	$38	116%
Blue Cross Blue Shield	$49 - $88	150%
Health Select	$53 - $66	162%
90 Degree Benefits	$60 - $101	183%
State Comptroller	$62	189%
Workers Comp	$64	196%
Healthsmart Preferred Care	$74 - $114	226%
Texas Mutual Wc	$82	251%
Caprock	$104 - $122	318%
Firstcare	$110	336%
Geha	$147	449%
Cigna	$218	666%

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 $79.
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 Medical Center 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.