Physical therapy (neuromuscular re-education)
Facility: Mount Sinai Rehabilitation Hospital Inc
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $194
- Cash Discount Price: $1,439
- vs. Medicare Baseline: 5.93x 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 593% of the Medicare baseline (a markup of 493%). 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 |
|---|---|---|
| Aetna | $34 - $299 | 104% |
| Medicare (plans) | $34 - $35 | 104% |
| UnitedHealthcare | $34 - $224 | 104% |
| Blue Cross Blue Shield | $34 - $457 | 104% |
| Cca Senior Care Options | $35 | 107% |
| Cigna | $35 - $399 | 107% |
| Diversified Administrators | $72 | 220% |
| Innovative Health Plan II | $72 | 220% |
| Claimdoc | $72 | 220% |
| Connecticut Dept of Correction | $124 | 379% |
| Magnacare | $133 - $399 | 406% |
| Allegiance | $133 - $399 | 406% |
| Health Partners | $133 - $399 | 406% |
| Health New England | $151 | 461% |
| Kaiser Domestic | $152 - $457 | 464% |
| Pre-Employment | $152 - $457 | 464% |
| Wc Domestic | $152 - $457 | 464% |
| Blue Shield - Wa (Regence) | $152 - $457 | 464% |
| Bcn Domestic | $152 - $457 | 464% |
| Blue Shield - Ny Highmark Western | $152 - $457 | 464% |
| Blue Shield - Id (Regence) | $152 - $457 | 464% |
| Blue Shield - PA (Highmark) | $152 - $457 | 464% |
| Health Choices | $152 - $457 | 464% |
| Blue Shield - Ny Highmark Northeastern | $152 - $457 | 464% |
| Blue Care Network | $152 - $457 | 464% |
| Unicare | $152 - $457 | 464% |
| Blue Benefit Administrators of Massachusetts | $152 - $457 | 464% |
| Blue Shield - Ca | $152 - $457 | 464% |
| Blue Distinction Transplant | $152 - $457 | 464% |
| Family Life Insurance Company | $194 | 593% |
| Allied National Global Care | $194 | 593% |
| Mvp | $194 | 593% |
| Ghc Scw | $194 | 593% |
| Paramount HMO | $194 | 593% |
| Pai | $194 | 593% |
| Dean Health | $194 | 593% |
| Lifetime Benefit Solutions | $194 | 593% |
| Christian Care Ministry | $194 | 593% |
| PHCS | $194 | 593% |
| Multiplan | $194 | 593% |
| Trinity Health Share | $194 | 593% |
| International Benefit Administrators | $194 | 593% |
| Medi Share | $194 | 593% |
| Manhattan Life | $194 | 593% |
| Pan-American Life | $194 | 593% |
| Asrm - Reliance Standard Life Insurance | $194 | 593% |
| Harvard Pilgrim Healthcare | $224 | 684% |
| Geha | $224 | 684% |
| Prime Health Services | $228 | 697% |
| Health Smart | $242 | 739% |
| Webtpa | $299 | 914% |
| Hap | $299 | 914% |
| Meritain | $299 | 914% |
| Luminare Health | $299 | 914% |
| 1199 National Benefit Fund | $299 | 914% |
| Nippon Life Ins | $299 | 914% |
| Allied Benefit Systems | $299 | 914% |
| Gravie Admin Services | $299 | 914% |
| Connecticare | $354 - $402 | 1082% |