CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Texas Orthopedic Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $41
  • Cash Discount Price: $350
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Texas Orthopedic Hospital is $41. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $350. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.25x the Medicare baseline. Located in 7401 South Main Street, Houston, TX.
Cash / Self-Pay
$350

Average discount available for prompt cash payment at this facility.

Insurance Median
$41

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: $350 (1069%)
Insurance Median: $41 (125%)
Cash: $350 (1069% of Medicare)
Ins. Median: $41 (125% 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 $21 - $35 64%
Oscar $28 - $73 86%
Amerigroup $29 - $52 89%
Blue Cross Blue Shield $29 - $131 89%
Cigna $29 - $33 89%
Devoted Health $29 - $33 89%
Humana $29 - $335 89%
Kelsey Seybold $29 - $33 89%
Triwest Healthcare Alliance $29 - $33 89%
Van Lang Ipa $29 - $33 89%
Wellmed $29 - $33 89%
American Health Plan $30 - $35 92%
Integranet Amerigroup Ipa $30 - $34 92%
Procare Advantage $30 - $35 92%
Shared Health $30 - $35 92%
United $30 - $168 92%
Wellcare $30 - $34 92%
Provider Partners Health Plan Of Texas $31 - $35 95%
Molina $32 - $36 98%
Christus (Usfhp) $33 101%
Universal Healthcare Group $35 - $39 107%
Verda Health Plan $38 - $43 116%
Community Health Choice $42 - $48 128%
Superior $42 - $51 128%
Community Health Choice Mcd $45 - $49 137%
Corvel Corporation $57 - $65 174%
Texas Childrens Health Plans $58 - $89 177%
Omni Healthcare $61 - $69 186%
Molina Healthcare $63 - $72 192%
Texas Workforce Commission $84 - $90 257%
Aetna $90 - $163 275%
Healthsmart Preferred Care $150 - $318 458%
Fidelis Securecare Of Tx $157 - $168 480%
Coventry National First Health $186 - $199 568%
Physicians Cooperative Of Texas $192 - $206 587%
Rockport Workers Comp $192 - $206 587%
Independent Medical System $210 - $224 642%
National Healthcare Solutions $210 - $224 642%
Southwest Medical $210 - $224 642%
Coastal Comp $227 - $243 694%
Multiplan $262 - $318 800%
International Health Insurance $280 - $299 855%
Physicians, Inc $297 - $318 907%
Texas Athletic Network $300 - $600 917%
Affiliated Ppo $315 - $337 962%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7401 South Main Street, Houston, TX 77030
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals