CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Lewisgale Hospital Pulaski

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $85
  • Cash Discount Price: $260
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Lewisgale Hospital Pulaski is $85. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $260. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.60x the Medicare baseline. Located in 2400 Lee Highway, Pulaski, VA.
Cash / Self-Pay
$260

Average discount available for prompt cash payment at this facility.

Insurance Median
$85

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: $260 (794%)
Insurance Median: $85 (260%)
Cash: $260 (794% of Medicare)
Ins. Median: $85 (260% 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 260% of the Medicare baseline (a markup of 160%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Humana $24 - $33 73%
Triatlantic $27 82%
Devoted $29 - $33 89%
Good Samaritan Hospice $29 - $33 89%
Health Net $29 89%
Magellan $29 - $33 89%
Sentara Health $29 - $33 89%
United $29 - $125 89%
United Mine Workers $29 - $33 89%
Aetna $30 - $125 92%
Blue Cross Blue Shield $30 - $34 92%
Cigna $30 - $35 92%
Evernorth Behavioral Health $30 - $35 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%
Lifeworks $46 - $53 141%
Universal Healthcare Group $53 - $61 162%
Virginia Health Network $85 - $197 260%
Greenvbrier Sporting Club $145 - $167 443%
Corvel $174 - $200 532%
Richfield Nursing Center $182 - $208 556%
Richfield Retirement Community $182 - $208 556%
Multiplan $186 - $214 568%
Community Care Network $194 - $222 593%
Graham-White Manufacturing $194 - $222 593%
Occunet Workers Comp $194 - $222 593%
One Health Plan $194 - $222 593%
Patients Choice $213 - $245 651%
4Most $218 - $250 666%
American Postal Workers Union $218 - $250 666%
Phcs $218 - $250 666%
Star Transportation $218 - $250 666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 Lee Highway, Pulaski, VA 24301
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals