CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Medical City Plano

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $34
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Medical City Plano is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 3901 W 15Th St, Plano, TX.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $170 (519%)
Insurance Median: $34 (104%)
Cash: $170 (519% of Medicare)
Ins. Median: $34 (104% 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 $12 - $33 37%
Cigna $23 - $33 70%
Blue Cross Blue Shield $27 - $191 82%
Aetna $28 - $179 86%
Amerigroup $28 - $32 86%
Care N Care $28 - $32 86%
Devoted Health $28 - $32 86%
Humana $28 - $246 86%
Mutual Of Omaha $28 - $32 86%
Triwest Veterans $28 - $32 86%
United $28 - $32 86%
Wellmed $28 - $32 86%
American Health Plan Of Texas, Inc. $29 - $33 89%
Integranet $29 - $33 89%
Procare Advantge $29 - $33 89%
Wellcare $29 - $33 89%
Provider Partners Health Plan $30 - $34 92%
Texas Independent Health Plan $30 - $34 92%
Imperial Insurance Company $31 - $35 95%
Molina $31 - $35 95%
Triwest Health Alliance $31 95%
Universal Healthcare Group $34 - $38 104%
Oscar $35 107%
Verda Health Plan $36 - $41 110%
Bravo Health $42 - $48 128%
Superior $50 - $71 153%
Lifecare Hospitals $51 156%
Usa Managed Care $53 - $136 162%
Corvel Corporation $56 - $63 171%
Healthcare Highways $57 174%
Prominence Health Plan $68 208%
Molina Healthcare $74 - $84 226%
City Of Mckinney $76 232%
Fidelis Securecare $76 232%
National Choicecare $85 260%
Pc Texas Partners $93 284%
Physicians Coop Of Tx $93 284%
Rockport Health Group $93 284%
Averde Health, Inc $98 299%
Texas Healthcare Foundation Wc $110 336%
Coastal Comp Health Networks $119 364%
Mega Life $119 364%
Multiplan Phcs $119 364%
Healthsmart Preferred Care $127 388%
Lewisville Isd/Dls Consulting $127 388%
Usc Health Services $136 416%
Galaxy Health Network $144 440%
Independent Medical Systems $170 519%
National Healthcare Solutions $170 519%
Unicare $170 519%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3901 W 15Th St, Plano, TX 75075
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals