CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: El Campo Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $37
Cash Discount Price: $156
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at El Campo Memorial Hospital is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 303 Sandy Corner Rd, El Campo, TX.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $156 (477%)

Insurance Median: $37 (113%)

Cash: $156 (477% of Medicare)

Ins. Median: $37 (113% 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
Molina	$30 - $37	92%
Triwest	$30	92%
UnitedHealthcare	$30 - $85	92%
Community Health Choice	$31 - $37	95%
Aetna	$37 - $117	113%
Amerigroup	$37	113%
Texas Children'S Health Plan	$37	113%
Blue Cross Blue Shield	$50	153%

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 $156.
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 El Campo Memorial Hospital 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.