CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Lewisgale Hospital Montgomery

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $34
Cash Discount Price: $152
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Lewisgale Hospital Montgomery is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 3700 South Main Street, Blacksburg, VA.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $152 (464%)

Insurance Median: $34 (104%)

Cash: $152 (464% of Medicare)

Ins. Median: $34 (104% 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
Cigna	$26 - $35	79%
Triatlantic	$27	82%
Devoted	$29 - $33	89%
Good Samaritan Hospice	$29 - $33	89%
Health Net	$29	89%
Humana	$29 - $33	89%
Lifeworks	$29	89%
Sentara Health	$29 - $33	89%
United	$29 - $68	89%
United Mine Workers	$29 - $33	89%
Aetna	$30 - $34	92%
Blue Cross Blue Shield	$30 - $34	92%
Virginia Premier Health	$30 - $34	92%
Align Senior Care	$31 - $36	95%
Clear Spring Health Plan	$31 - $35	95%
Pyramid Life	$31 - $36	95%
Universal Healthcare Group	$33	101%
Virginia Health Network	$53 - $108	162%
Greenvbrier Sporting Club	$91	278%
Corvel	$109	333%
Richfield Nursing Center	$114	348%
Richfield Retirement Community	$114	348%
Multiplan	$117	357%
Community Care Network	$122	373%
Graham-White Manufacturing	$122	373%
Occunet Workers Comp	$122	373%
One Health Plan	$122	373%
Phcs	$129	394%
Patients Choice	$134	409%
4Most	$137	419%
American Postal Workers Union	$137	419%
Star Transportation	$137	419%

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 $152.
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 Lewisgale Hospital Montgomery 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.