CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: St David's Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $41
  • Cash Discount Price: $176
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at St David's Medical Center is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $176. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.25x the Medicare baseline. Located in 919 E 32Nd St, Austin, TX.
Cash / Self-Pay
$176

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $176 (538%)
Insurance Median: $41 (125%)
Cash: $176 (538% of Medicare)
Ins. Median: $41 (125% 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
Superior Health Plan $6 - $52 18%
Oscar $24 - $65 73%
Wellmed $27 - $33 82%
Aetna $28 - $210 86%
Blue Cross Blue Shield $28 - $205 86%
Cigna $28 - $34 86%
Devoted Health $28 - $34 86%
Humana $28 - $34 86%
Odyssey Hospice $28 - $34 86%
St David’S Hospice $28 - $34 86%
Triwest Healthcare Alliance $28 - $34 86%
American Health Plan Of Texas $29 - $35 89%
Moda $29 - $71 89%
Shared Health $29 - $35 89%
United $29 - $136 89%
Provider Partners Health Plan $30 - $36 92%
Pyramid Life $30 - $36 92%
Texas Independent Health Plan $30 - $36 92%
Triwest Veterans $30 - $34 92%
Wellcare $30 - $36 92%
Imperial Insurance $31 - $37 95%
Molina Healthcare $31 - $37 95%
Triwest Health Alliance $31 - $33 95%
Amerigroup $34 104%
Universal Health $34 - $40 104%
Austin Fc $35 - $42 107%
Covenant Management Systems $36 - $87 110%
Healthcare Highways $36 - $91 110%
Imo Med - Select Network $37 - $91 113%
Sendero $38 - $58 116%
Naphcare $44 - $52 134%
Moda Health $45 - $112 137%
Seven Corners $46 - $52 141%
Texas Healthcare Foundation Heb $46 - $112 141%
Texas Workforce Commission $48 - $118 147%
Averde Health $56 - $136 171%
Corvel Corporation $56 - $67 171%
Comanche County $62 - $152 189%
National Choicecare $62 - $152 189%
Healthsmart Preferred Care $68 - $242 208%
Independent Medical Systems $68 - $167 208%
Physicians Cooperative Of Texas $68 - $167 208%
Prime Health $74 - $182 226%
First Health $78 - $218 238%
Coastal Comp Health Networks $81 - $197 247%
National Health Care $81 - $197 247%
Occunet $87 - $212 266%
Texas Municipal League $87 - $212 266%
Medcorp Southwest $93 - $227 284%
Rockport Healthcare Group $99 - $273 302%
Bce Emergis Corporation $112 - $273 342%
Beech Street $112 - $273 342%
Medical Control Network Solutions $112 - $273 342%
Multiplan $112 - $273 342%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 919 E 32Nd St, Austin, TX 78705
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals