CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: PAM Rehabilitation Hospital of Clear Lake

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $67
Cash Discount Price: $90
vs. Medicare Baseline: 2.05x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at PAM Rehabilitation Hospital of Clear Lake is $67. 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 2.05x the Medicare baseline. Located in 110 East Medical Center Boulevard, Webster, TX.

Cash / Self-Pay

$90

Average discount available for prompt cash payment at this facility.

Insurance Median

$67

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: $67 (205%)

Cash: $90 (275% of Medicare)

Ins. Median: $67 (205% 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 205% of the Medicare baseline (a markup of 105%). 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	$9 - $22	27%
Wellpoint (Amerigroup)	$22	67%
Curative	$24	73%
Community Health Choice	$32	98%
Caresource	$34	104%
Christus Health Plan	$36	110%
Scan Health Plan	$36	110%
Ninety Degree Benefits	$45	137%
Healthcare Highways	$49	150%
America'S Choice Provider Network	$63	192%
Provider Network Of America	$67	205%
Quik Trip	$67	205%
Usa Managed Care Organization	$67	205%
Velocity Provider Ppo Network	$67	205%
Cigna	$70 - $115	214%
Memorial Hermann Health Plan	$70	214%
Multiplan/Phcs	$72	220%
Prime Health Services	$76	232%
Medincrease	$81	247%
Select Care	$90	275%
Today'S Option	$90	275%

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 PAM Rehabilitation Hospital of Clear Lake 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.