CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: St David's South Austin Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $42
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at St David's South Austin Medical Center is $42. 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 1.28x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $42 (128%)
Cash: $170 (519% of Medicare)
Ins. Median: $42 (128% 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 $8 - $35 24%
Wellmed $29 - $33 89%
Aetna $30 - $210 92%
Blue Cross Blue Shield $30 - $205 92%
Cigna $30 - $53 92%
Devoted Health $30 - $34 92%
Harbor Hospice $30 - $34 92%
Humana $30 - $34 92%
Odyssey Hospice $30 - $34 92%
Oscar $30 - $39 92%
St David’S Hospice $30 - $34 92%
Triwest Veterans $30 - $34 92%
United $30 - $83 92%
American Health Plan Of Texas $31 - $35 95%
Provider Partners Health Plan $31 - $36 95%
Shared Health $31 - $35 95%
Texas Independent Health Plan $31 - $36 95%
Wellcare $31 - $36 95%
Molina Healthcare $32 - $37 98%
Pyramid Life $32 - $36 98%
Imperial Insurance $33 - $37 101%
Triwest Health Alliance $33 101%
Amerigroup $34 104%
Moda $36 - $43 110%
Universal Health $36 - $40 110%
Austin Fc $37 - $42 113%
Sendero $40 - $58 122%
Covenant Management Systems $45 - $53 137%
Healthcare Highways $45 - $55 137%
Imo Med - Select Network $46 - $55 141%
Naphcare $46 - $52 141%
Seven Corners $46 - $52 141%
Moda Health $56 - $68 171%
Texas Healthcare Foundation Heb $57 - $68 174%
Corvel Corporation $59 - $67 180%
Texas Workforce Commission $60 - $72 183%
Averde Health $70 - $83 214%
UnitedHealthcare $74 - $184 226%
Comanche County $78 - $92 238%
Emerging Therapy Solutions $78 - $127 238%
National Choicecare $78 - $92 238%
Healthsmart Preferred Care $85 - $147 260%
Independent Medical Systems $85 - $101 260%
Physicians Cooperative Of Texas $85 - $101 260%
Prime Health $93 - $110 284%
First Health $98 - $132 299%
Coastal Comp Health Networks $101 - $120 309%
National Health Care $101 - $120 309%
Occunet $108 - $129 330%
Texas Municipal League $108 - $129 330%
Medcorp Southwest $116 - $138 354%
Rockport Healthcare Group $124 - $166 379%
Bce Emergis Corporation $140 - $166 428%
Beech Street $140 - $166 428%
Medical Control Network Solutions $140 - $166 428%
Multiplan $140 - $166 428%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 901 West Ben White Blvd, Austin, TX 78704
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals