CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Beloit Health System

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $190
  • Cash Discount Price: $68
  • vs. Medicare Baseline: 5.81x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Beloit Health System is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.81x the Medicare baseline. Located in 1969 W Hart Rd, Beloit, WI.
Cash / Self-Pay
$68

Average discount available for prompt cash payment at this facility.

Insurance Median
$190

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: $68 (208%)
Insurance Median: $190 (581%)
Cash: $68 (208% of Medicare)
Ins. Median: $190 (581% 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 581% of the Medicare baseline (a markup of 481%). 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
Aetna $66 - $235 202%
Quartz $104 - $170 318%
Cook Children'S Health Plan (Cchp) $119 364%
The Alliance $119 - $132 364%
Humana $124 - $210 379%
Blue Cross Blue Shield $126 - $363 385%
Wea Trust $130 - $144 397%
Dean Health $133 - $146 406%
Naphcare $142 - $157 434%
Wps $176 - $193 538%
UnitedHealthcare $178 - $196 544%
Multiplan $190 - $209 581%
Health Eos $211 - $232 645%
Cigna $218 - $240 666%
Hfn $218 - $240 666%
Preferred Network Access $218 - $240 666%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1969 W Hart Rd, Beloit, WI 53511
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals