CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Yoakum Community Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $92
  • Cash Discount Price: $75
  • vs. Medicare Baseline: 2.81x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Yoakum Community Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $75. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.81x the Medicare baseline. Located in 1200 Carl Ramert Drive, Yoakum, TX.
Cash / Self-Pay
$75

Average discount available for prompt cash payment at this facility.

Insurance Median
$92

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: $75 (229%)
Insurance Median: $92 (281%)
Cash: $75 (229% of Medicare)
Ins. Median: $92 (281% 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 281% of the Medicare baseline (a markup of 181%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $48 - $131 147%
Humana $48 147%
Medicare (plans) $48 147%
Prime Health Svcs Mcr Advantage $48 147%
Scott & White Mcare Advan $48 147%
Superior Mcr Advantage $48 147%
Triwest Va Ccn-All Plans $48 147%
Tx Independent Hp Mcr Advantage-All Plans $48 147%
UnitedHealthcare $48 - $93 147%
Superior Hix-All Other Plans $59 180%
Kempton Group Admin Ppo-All Plans $76 232%
Entrust - All Plans $81 247%
Medicaid / KanCare $84 - $116 257%
Amera-Net-All Plans $87 266%
Scott & White Ppo-All Other Plans $87 266%
Healthsmart Ppo-All Other Plans $90 275%
Blue Bell Creameries Emp-All Plans $93 284%
Cigna $93 284%
Americas Health Plan-All Plans $99 302%
Beech Street-All Plans $99 302%
Directcare America-All Plans $99 302%
Galaxy Ppo - All Plans $99 302%
Health Star Comm Ip/Op Only - All Plans $99 302%
Medcorp Southwest Ppo-All Plans $99 302%
Medical Control Ppo-All Plans $99 302%
Phcs Multiplan - All Plans $99 302%
Aetna $104 318%
Healthsmart Work Comp $104 318%
Prime Health Svcs Ppo-All Other Plans $104 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Carl Ramert Drive, Yoakum, TX 77995
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals