CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Yoakum County Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $70
  • Cash Discount Price: $84
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Yoakum County Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.14x the Medicare baseline. Located in 412 Mustang Avenue, Denver City, TX.
Cash / Self-Pay
$84

Average discount available for prompt cash payment at this facility.

Insurance Median
$70

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: $84 (257%)
Insurance Median: $70 (214%)
Cash: $84 (257% of Medicare)
Ins. Median: $70 (214% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
90 Degree Benefits $35 107%
Firstcare $37 - $45 113%
Multiplan $37 - $89 113%
Humana $52 - $66 159%
Insurance Services Of Lubbock $52 - $66 159%
UnitedHealthcare $52 - $82 159%
Aetna $53 - $87 162%
Dars $56 - $72 171%
Healthsmart $68 - $86 208%
Phcs $68 - $87 208%
Cigna $70 214%
Capstar $72 - $92 220%
Provider Network $78 - $100 238%
Blue Cross Blue Shield $80 - $102 244%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 412 Mustang Avenue, Denver City, TX 79323
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals