CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Crossing Rivers Health Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $159
Cash Discount Price: $167
vs. Medicare Baseline: 4.86x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Crossing Rivers Health Medical Center is $159. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $167. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.86x the Medicare baseline. Located in 37868 Us Hwy 18, Prairie Du Chien, WI.

Cash / Self-Pay

$167

Average discount available for prompt cash payment at this facility.

Insurance Median

$159

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: $167 (510%)

Insurance Median: $159 (486%)

Cash: $167 (510% of Medicare)

Ins. Median: $159 (486% 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 486% of the Medicare baseline (a markup of 386%). 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
Amerigroup Mcr Adv	$70	214%
Blue Cross Blue Shield	$70 - $162	214%
Security Hlth Mcr Adv	$70	214%
UnitedHealthcare	$70	214%
Humana	$71 - $160	217%
Amerigroup Mcaid-All Other Plans	$74	226%
Iowa Total Care Mcaid-All Plans	$74	226%
Quartz - All Plans	$134	409%
Dean Health Plan - All Plans	$159	486%
Medica Comm - All Other Plans	$159	486%
Medica Hp Solutions	$159	486%
Security Hlth Comm - All Other Plans	$159	486%
Health Trad Hp - All Plans	$160	489%
Wea Provider Ntwrk - All Plans	$160	489%
Cigna	$162	495%
First Health - All Plans	$162	495%
Geha - All Plans	$162	495%
Group Health Co-Op - All Plans	$162	495%
Health Partners - All Plans	$162	495%
Medical Associates Hp - All Plans	$162	495%
Preferred Health Choice - All Plans	$162	495%
Wps - All Plans	$162	495%

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 $167.
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 Crossing Rivers Health Medical Center 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.