CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Seton Medical Center Harker Heights

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $173
Cash Discount Price: $44
vs. Medicare Baseline: 5.29x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Seton Medical Center Harker Heights is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $44. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.29x the Medicare baseline. Located in 850 W Central Texas Expressway, Harker Heights, TX.

Cash / Self-Pay

$44

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $44 (134%)

Insurance Median: $173 (529%)

Cash: $44 (134% of Medicare)

Ins. Median: $173 (529% 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 529% of the Medicare baseline (a markup of 429%). 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
Medicaid / KanCare	$30 - $173	92%
Blue Cross Blue Shield	$77 - $328	235%
Healthscope Benefits [2290]	$80	244%
UnitedHealthcare	$80 - $173	244%
Aetna	$82 - $254	251%
Bell County Indigent Health Svc [3530]	$84	257%
Healthcare Highways [2210]	$173	529%
Oncology Patient Assistance Programs [2295]	$173	529%
Selecthealth [3740]	$173	529%
Web Tpa [2115]	$173 - $354	529%
Humana	$290 - $320	886%
First Care Commercial [1371]	$332	1014%
Allied Benefit Systems Inc [1030]	$354	1082%
Cigna	$384	1173%

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 $44.
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 Seton Medical Center Harker Heights 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.