Physical therapy (neuromuscular re-education)
Facility: Lindsborg Community Hospital
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $93
- Cash Discount Price: $75
- vs. Medicare Baseline: 2.84x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 284% of the Medicare baseline (a markup of 184%). 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Coventry Mcr Adv | $31 - $65 | 95% |
| Tricare | $31 - $65 | 95% |
| Blue Cross Blue Shield | $50 | 153% |
| Cigna | $55 - $117 | 168% |
| UnitedHealthcare | $58 - $124 | 177% |
| Coventry Comm-All Other Plans | $58 - $124 | 177% |
| Phcs Preferred-All Plans | $60 - $128 | 183% |
| Multiplan-All Plans | $60 - $128 | 183% |
| Century Health-All Plans | $62 - $130 | 189% |
| Coventry Wc | $62 - $130 | 189% |
| Wppa-All Plans | $62 - $130 | 189% |
| Health Partners -All Plans | $62 - $130 | 189% |
Consumer Guidance & Cost Commentary
For the CPT code 97112 (Physical therapy, neuromuscular re-education) at Lindsborg Community Hospital, the cash median price is $75.00, which is lower than the facility's negotiated rates of $93.00 to $96.00. This aligns with the principle that cash-pay can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price. While the facility is a Critical Access Hospital in Kansas, the data does not provide specific county or state average benchmarks for this procedure, so direct comparisons to regional averages are not available in this report. However, the gross charge of $107.00 serves as the starting point for all billing, and patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling to potentially reduce the final amount owed.
When using insurance, the allowed amounts vary significantly by payer, ranging from a low of $31.00 to a high of $130.00, with the median paid amount being $96.00. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract dynamics, meaning that in-network coverage does not always guarantee the lowest possible price. Furthermore, while Medicare sets a benchmark of $32.73 for this service, commercial rates can average 200% to 300% of this baseline. Patients should be aware of their deductible status before relying on insurance, as high negotiated rates may still require out-of-pocket payment if the deductible has not been met, and they should request an itemized bill to ensure no errors