CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Rio Grande Regional Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $45
  • Cash Discount Price: $732
  • vs. Medicare Baseline: 1.37x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Rio Grande Regional Hospital is $45. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $732. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.37x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
$732

Average discount available for prompt cash payment at this facility.

Insurance Median
$45

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: $732 (2236%)
Insurance Median: $45 (137%)
Cash: $732 (2236% of Medicare)
Ins. Median: $45 (137% 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
Aetna $28 - $32 86%
Allegian Health $28 - $32 86%
Blue Cross Blue Shield $28 - $373 86%
Cigna $28 - $32 86%
Humana $28 - $469 86%
Independent Medical System $28 - $32 86%
Triwest Healthcare Alliance $28 - $32 86%
Wellmed $28 - $31 86%
American Health Plan $29 - $33 89%
Physicians Health Choice $29 - $33 89%
Prominence Health $29 - $33 89%
Shared Health $29 - $33 89%
Superior Health Plan $29 - $58 89%
United $29 - $373 89%
Provider Partners Health Plan Of Texas $30 - $34 92%
Molina $31 - $35 95%
Triwest Health Alliance $31 95%
Universal Health Care $34 - $38 104%
Superior $44 - $49 134%
Corvel Corporation $56 - $63 171%
Focus Healthcare $56 - $64 171%
Omni Healthcare $59 - $67 180%
Molina Healthcare $68 - $78 208%
Texas Workforce Commission $153 - $199 467%
Oscar $173 - $225 529%
Averde Health $210 - $273 642%
Healthsmart Preferred Care $273 - $704 834%
Texas Athletic Network $300 - $600 917%
First Health $366 - $476 1118%
National Healthcare Solutions $381 - $497 1164%
Southwest Medical $381 - $497 1164%
Coastal Comp $413 - $538 1262%
Usa Managed Care $413 - $663 1262%
Ppo Next/ Medical Control $477 - $621 1457%
Beech Street $509 - $663 1555%
Multiplan $509 - $663 1555%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals