CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Childrens Medical Center Plano

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $145
Cash Discount Price: $155
vs. Medicare Baseline: 4.43x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Childrens Medical Center Plano is $145. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.43x the Medicare baseline. Located in 7601 Preston Road, Plano, TX.

Cash / Self-Pay

$155

Average discount available for prompt cash payment at this facility.

Insurance Median

$145

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: $155 (474%)

Insurance Median: $145 (443%)

Cash: $155 (474% of Medicare)

Ins. Median: $145 (443% 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 443% of the Medicare baseline (a markup of 343%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$28 - $145	86%
Humana	$28 - $155	86%
Medicaid / KanCare	$28	86%
Oklahoma Complete Health	$28	86%
Superior Health Plan	$41	125%
Firstcare Health	$47	144%
Parkland Community	$68	208%
Cookchildren'S Health Plan	$70	214%
Molina Healthcare	$72	220%
Carelon	$77 - $101	235%
Texas Children'S Health Plan	$79	241%
Wellpoint	$79	241%
Blue Cross Blue Shield	$83 - $141	254%
UnitedHealthcare	$110 - $155	336%
Methodist	$118	361%
Cigna	$137 - $143	419%
Employers Health Network	$145	443%
Imagine Health	$145	443%
Scott & White	$147	449%
Txp Emerging Therapy Solutions	$147	449%
Healthsmart	$151 - $176	461%
Healthscope Benefit Solutions	$155	474%
Phcs	$155	474%
Quiktrip (Qt)	$155	474%
Txp Interlink	$155	474%
Coventry Health	$166	507%
Equifax Healthcare	$176	538%
Multiplan	$176	538%
Usa Managed Care	$193	590%
Galaxy Health	$201	614%

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 $155.
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 Childrens Medical Center Plano 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.