CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: The Medical Center of Southeast Texas

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $44
  • Cash Discount Price: $233
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at The Medical Center of Southeast Texas is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.34x the Medicare baseline. Located in 2555 Jimmy Johnson Blvd, Port Arthur, TX.
Cash / Self-Pay
$233

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $233 (712%)
Insurance Median: $44 (134%)
Cash: $233 (712% of Medicare)
Ins. Median: $44 (134% 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
Community Health Choice $13 - $38 40%
Amerigroup $18 - $31 55%
Community Health Choice Uhrip $18 55%
Harbor Hospice $18 55%
Medicaid / KanCare $18 - $36 55%
Texas Childrens Health Plan $18 - $19 55%
Molina Healthcare $19 - $43 58%
UnitedHealthcare $19 - $131 58%
Beacon Health $21 64%
Medsolutions $28 86%
Humana $30 - $213 92%
Healthspring $31 95%
Medicare (plans) $31 95%
Provider Partners Health Plan $31 95%
Selectcare $31 95%
Superior Healthplan $31 - $50 95%
Tihp (Texas Independence Health Plan) $31 95%
Caresact $32 98%
Employer Direct Healthcare $32 - $40 98%
Hospice $32 98%
Rice Land Hospice $32 98%
Texas Medical Management Partners $32 - $40 98%
Tricare $32 98%
Triwest $32 98%
Cccn Pro Advantage $33 101%
Wellcare Of Texas $33 101%
Blue Cross Blue Shield $34 - $198 104%
League Medical Concepts $35 107%
Self Pay Emergent $35 107%
Wellpath $35 107%
Corporate Remedies $47 144%
Elap Services $62 189%
Texas Workers Compensation $64 196%
Cigna $116 - $163 354%
Dept Of Assistive And Rehabilitative Services $116 354%
Aetna $135 - $154 412%
Iasis Employees $140 428%
Magellan Behavioral Health $140 428%
First Health $163 498%
Galaxy Health Network $163 498%
Private Healthcare Systems $163 498%
Texas Municipal League $163 498%
Healthsmart $175 535%
Multiplan $186 568%
Commercial Non-Contracted $233 712%
Heart To Heart Hospice $233 712%
Lifesynch $233 712%
Mhnet $233 712%
Self Pay - Mcd Pending 100 Percent $233 712%
Single Case Agreement $233 712%
United Behavioral Health $233 712%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2555 Jimmy Johnson Blvd, Port Arthur, TX 77640
  • CMS Rating: ★★★☆☆
  • Ownership Type: Physician
  • Hospital Type: Acute Care Hospitals