CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Methodist McKinney Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $42
Cash Discount Price: $90
vs. Medicare Baseline: 1.28x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Methodist McKinney Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 8000 W Eldorado Pkwy Bldg C Suite C, McKinney, TX.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$42

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: $90 (275%)

Insurance Median: $42 (128%)

Cash: $90 (275% of Medicare)

Ins. Median: $42 (128% 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.

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	$33 - $288	101%
Blue Cross Blue Shield	$33 - $74	101%
Medicare (plans)	$33 - $35	101%
UnitedHealthcare	$33 - $35	101%
Ust Health Proof [1005]	$33	101%
Wellcare [7016]	$33	101%
American Health Advantage Of Texas [7099]	$35	107%
Cigna	$35	107%
Globalhealth [1003]	$35	107%
Humana	$35	107%
Procare Advantage [7018]	$35	107%
Southwestern Health Resources Swhr [7015]	$35	107%
Provider Partners Health Plan [7025]	$36	110%
Alternative Service Concepts [8005]	$41	125%
Oscar Insurance Company [2057]	$43	131%
Bright Healthcare [2222]	$46	141%
Molina [3017]	$48	147%
Wellpoint Marketplace Exchange [3071]	$51	156%
90 Degree Benefit [3057]	$54	165%
Allied National [2031]	$54	165%
Entrust/90 Degree [2058]	$54	165%
Ambetter / Centene	$56	171%
Friday Health Plan [2061]	$56	171%
Imperial Insurance Companies [3073]	$59	180%
Evry Health [1013]	$66	202%
Sana Benefits [3069]	$66	202%
Velocity [3070]	$66	202%
Web Tpa [3049]	$265 - $288	810%

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 $90.
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 Methodist McKinney Hospital 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.