CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Bellin Memorial Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $68
Cash Discount Price: $62
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Bellin Memorial Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $62. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.08x the Medicare baseline. Located in 744 S Webster Ave, Green Bay, WI.

Cash / Self-Pay

$62

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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: $62 (189%)

Insurance Median: $68 (208%)

Cash: $62 (189% of Medicare)

Ins. Median: $68 (208% 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 208% of the Medicare baseline (a markup of 108%). 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	$25 - $28	76%
Blue Cross Blue Shield	$25 - $117	76%
Community Care	$25 - $53	76%
Humana	$25 - $53	76%
My Choice	$25 - $42	76%
Network Health	$25 - $265	76%
Chorus Community Health Plan	$61 - $95	186%
Aspirus Arise	$66 - $68	202%
UnitedHealthcare	$66 - $302	202%
Cigna	$67 - $68	205%
Wps Insurance	$69 - $81	211%
Hps/Paymedix	$70 - $76	214%
Trilogy	$72	220%
Healthsmart	$76	232%
Ihs(Claimsbridge)	$76	232%
Medical College Of Wi	$76	232%
Multiplan	$76	232%
Allied National	$81	247%
First Health	$81	247%
Galaxy Health	$81	247%
Three Rivers Provider Network	$86	263%
Common Ground	$126	385%

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 $62.
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 Bellin 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.