CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: PAM Health Rehabilitation Hospital of Sugar Land LLC

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $44
Cash Discount Price: $185
vs. Medicare Baseline: 1.34x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at PAM Health Rehabilitation Hospital of Sugar Land LLC is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.34x the Medicare baseline. Located in 7622 Branford Pl, Sugar Land, TX.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$44

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: $185 (565%)

Insurance Median: $44 (134%)

Cash: $185 (565% of Medicare)

Ins. Median: $44 (134% 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	$22 - $31	67%
Curative	$23	70%
Memorial Hermann Health Plan	$25 - $70	76%
Ambetter / Centene	$31	95%
Blue Cross Blue Shield	$31 - $34	95%
Community Health Choice	$31	95%
Ilumed Aco Reach	$31	95%
Molina Healthcare	$31	95%
UnitedHealthcare	$31 - $90	95%
Verda Healthcare	$31	95%
Wellcare Complete	$31	95%
Wellpoint (Amerigroup)	$31	95%
Caresource	$33	101%
Texas Independence Health Plan	$33	101%
Velocity Provider Ppo Network	$37 - $139	113%
Prime Health Services	$40 - $157	122%
Ninety Degree Benefits	$47	144%
Sana Benefits	$47	144%
Cigna	$70 - $115	214%
America'S Choice Provider Network	$130	397%
Quik Trip	$139	425%
Usa Managed Care Organization	$139	425%
Multiplan/Phcs	$148	452%

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 $185.
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 Health Rehabilitation Hospital of Sugar Land LLC 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.