CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Carrollton Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $32
Cash Discount Price: $112
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Carrollton Regional Medical Center is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $112. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 0.98x the Medicare baseline. Located in 4343 North Josey Lane, Carrollton, TX.

Cash / Self-Pay

$112

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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: $112 (342%)

Insurance Median: $32 (98%)

Cash: $112 (342% of Medicare)

Ins. Median: $32 (98% 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
Aetna	$16 - $48	49%
Amerigroup	$26 - $32	79%
Blue Cross Blue Shield	$26 - $128	79%
Cigna	$26	79%
Medicaid / KanCare	$26 - $27	79%
Molina	$26 - $33	79%
Superior	$26 - $48	79%
Superior_Chip	$26	79%
Uhc_Chip	$26	79%
Uhc_Star	$26	79%
Uhc_Star_Plus	$26	79%
UnitedHealthcare	$26 - $167	79%
Humana	$29 - $32	89%
Medicare (plans)	$32	98%
Scott_And_White	$32	98%
Molina_Star_Plus	$33	101%
Molina_Health_Insurance_Marketplace	$41	125%
Scott_And_White_Epo	$93	284%
Scott_And_White_Hmo	$93	284%
Scott_And_White_Ppo	$93	284%
Scott_And_White_Swhp	$93	284%
Phcs	$139	425%

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 $112.
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 Carrollton Regional Medical Center 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.