CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Methodist Hospital Atascosa

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $32
Cash Discount Price: $544
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Methodist Hospital Atascosa is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $544. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 1905 Hwy 97 East, Jourdanton, TX.

Cash / Self-Pay

$544

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: $544 (1662%)

Insurance Median: $32 (98%)

Cash: $544 (1662% 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
Superior Health	$27 - $33	82%
Wellmed	$27 - $30	82%
Blue Cross Blue Shield	$28 - $202	86%
Devoted Health	$28 - $32	86%
Gonzaba Medical Group	$28 - $32	86%
Ilumed	$28 - $32	86%
Triwest	$28 - $32	86%
Triwest Va Pccc	$28 - $31	86%
Aetna	$29 - $272	89%
American Health Plan Of Texas	$29 - $33	89%
Clover Insurance	$29 - $33	89%
Integranet	$29 - $33	89%
United	$29 - $245	89%
Wellcare	$29 - $33	89%
Texas Independent Health Plan	$30 - $34	92%
Triwest Health Alliance	$32	98%
Focus Healthcare Management	$39 - $45	119%
Community First Health Plans	$65 - $147	199%
Imperial Insurance	$103	315%
Oscar	$109	333%
Healthsmart Preferred Care	$299	914%
Multiplan	$408 - $463	1247%

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 $544.
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 Methodist Hospital Atascosa 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.