CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Intermountain Health Garfield Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $118
Cash Discount Price: $93
vs. Medicare Baseline: 3.61x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Intermountain Health Garfield Memorial Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $93. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 3.61x the Medicare baseline. Located in 200 North 400 East, Panguitch, UT.

Cash / Self-Pay

$93

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $93 (284%)

Insurance Median: $118 (361%)

Cash: $93 (284% of Medicare)

Ins. Median: $118 (361% 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 361% of the Medicare baseline (a markup of 261%). 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	$33 - $120	101%
Health Choice Utah	$33 - $111	101%
Healthy U	$33 - $111	101%
Medicare (plans)	$33 - $47	101%
Molina	$33 - $118	101%
Molina Healthcare Of Utah	$33 - $118	101%
Selecthealth	$33 - $118	101%
Triwest	$33 - $64	101%
Uofu	$33 - $118	101%
Tricare	$54 - $64	165%
UnitedHealthcare	$102 - $105	312%
Blue Cross Blue Shield	$118	361%
Byu Athletic Department	$118	361%
Campbell Scientific	$118	361%
Cigna	$118	361%
Deseret Mutual	$118	361%
Emi Health	$118	361%
Franklin County	$118	361%
Health Utah	$118	361%
Hygeia Corporation	$118	361%
Juniper Systems	$118	361%
Lw Miller	$118	361%
Managed Care Administrators, Inc.	$118	361%
Medcare International	$118	361%
Motivhealth	$118	361%
Pehp	$118	361%
Prodegi Corporate Benefit Services, Llc	$118	361%
Springtide	$118	361%
Tanner Llc	$118	361%
Utah State University	$118	361%
Utah Tech University	$118	361%
Wise	$118	361%

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 $93.
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 Intermountain Health Garfield Memorial 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.