CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Matagorda Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $73
Cash Discount Price: $54
vs. Medicare Baseline: 2.23x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Matagorda Regional Medical Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $54. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.23x the Medicare baseline. Located in 104 7Th Street, Bay City, TX.

Cash / Self-Pay

$54

Average discount available for prompt cash payment at this facility.

Insurance Median

$73

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: $54 (165%)

Insurance Median: $73 (223%)

Cash: $54 (165% of Medicare)

Ins. Median: $73 (223% 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 223% of the Medicare baseline (a markup of 123%). 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
Comm Care	$59 - $62	180%
Medicaid / KanCare	$59 - $62	180%
Molina	$59 - $62	180%
Scott & White	$59 - $62	180%
Superior	$59 - $62	180%
Tcstar	$59 - $62	180%
UnitedHealthcare	$59 - $77	180%
Wellpoint	$59 - $62	180%
Aetna	$66 - $70	202%
Humana	$68 - $72	208%
Coventry First Health	$74 - $78	226%
Galaxy Health	$74 - $78	226%
Cigna	$79 - $83	241%
Independent Medical System	$89 - $94	272%
Multiplan Phcs	$89 - $94	272%
Three Rivers	$89 - $94	272%
Blue Cross Blue Shield	$94 - $113	287%
Health Smart	$94 - $100	287%
Usa Managed	$94 - $100	287%

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 $54.
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 Matagorda Regional 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.