CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: North Austin Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $64
  • Cash Discount Price: $362
  • vs. Medicare Baseline: 1.96x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at North Austin Medical Center is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $362. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.96x the Medicare baseline. Located in 12221 Mopac Expressway North, Austin, TX.
Cash / Self-Pay
$362

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $362 (1106%)
Insurance Median: $64 (196%)
Cash: $362 (1106% of Medicare)
Ins. Median: $64 (196% 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 $17 - $64 52%
Wellmed $29 - $33 89%
Aetna $30 - $210 92%
Blue Cross Blue Shield $30 - $205 92%
Cigna $30 - $34 92%
Devoted Health $30 - $34 92%
Humana $30 - $34 92%
Odyssey Hospice $30 - $34 92%
St David’S Hospice $30 - $34 92%
Triwest Healthcare Alliance $30 - $34 92%
United $30 - $169 92%
UnitedHealthcare $30 - $169 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%
Universal Health $36 - $40 110%
Austin Fc $37 - $42 113%
Sendero $40 - $58 122%
Naphcare $46 - $52 141%
Seven Corners $46 - $52 141%
Corvel Corporation $59 - $67 180%
Oscar $67 - $80 205%
Moda $82 - $88 251%
Covenant Management Systems $100 - $108 306%
Healthcare Highways $101 - $112 309%
Imo Med - Select Network $104 - $112 318%
Moda Health $125 - $139 382%
Texas Healthcare Foundation Heb $129 - $139 394%
Texas Workforce Commission $136 - $146 416%
Averde Health $157 - $169 480%
Comanche County $174 - $188 532%
National Choicecare $174 - $188 532%
Healthsmart Preferred Care $191 - $300 584%
Independent Medical Systems $191 - $206 584%
Physicians Cooperative Of Texas $191 - $206 584%
Prime Health $209 - $225 639%
First Health $218 - $266 666%
Coastal Comp Health Networks $226 - $244 690%
National Health Care $226 - $244 690%
Texas Municipal League $244 - $262 745%
Medcorp Southwest $261 - $281 797%
Rockport Healthcare Group $278 - $338 849%
Bce Emergis Corporation $313 - $338 956%
Beech Street $313 - $338 956%
Medical Control Network Solutions $313 - $338 956%
Multiplan $313 - $338 956%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12221 Mopac Expressway North, Austin, TX 78758
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals