Physical therapy (neuromuscular re-education)
Facility: Ann & Robert H Lurie Childrens Hospital of Chicago
Billing Code: 97112 (CPT)
- CPT Billing Code: 97112
- Insurance Median: $139
- Cash Discount Price: $122
- vs. Medicare Baseline: 4.25x 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 425% of the Medicare baseline (a markup of 325%). 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 |
|---|---|---|
| Medicare (plans) | $30 - $2,656 | 92% |
| Mercycare Health | $64 | 196% |
| Cigna | $73 - $124 | 223% |
| Blue Cross Blue Shield | $75 - $139 | 229% |
| La Rabida Childrens Hospital | $87 | 266% |
| Aetna | $87 - $136 | 266% |
| Beacon Health Options | $87 | 266% |
| UnitedHealthcare | $100 - $118 | 306% |
| Independent Physicians at Mercy | $104 | 318% |
| Centegra | $104 | 318% |
| Northwest Community Healthcare | $122 | 373% |
| St. Francis | $122 | 373% |
| Advanced Physicians Association IPA | $122 | 373% |
| Health Plus | $122 | 373% |
| West Suburban Health Providers | $122 | 373% |
| Methodist First Choice | $122 | 373% |
| Presence Health Partners | $122 | 373% |
| Imagine Health | $122 | 373% |
| Ui Health | $122 | 373% |
| Swedish Covenant Physician Partners | $130 | 397% |
| Shriners Hospital | $130 | 397% |
| Health Alliance | $139 | 425% |
| Macneal Health | $139 | 425% |
| American Psych Systems | $139 | 425% |
| Magellan | $139 - $900 | 425% |
| Healthlink Inc. | $144 | 440% |
| Principal Healthcare | $148 | 452% |
| St. Elizabeth | $148 | 452% |
| Hfn Inc | $148 - $157 | 452% |
| Cofinity | $148 | 452% |
| Humana | $148 | 452% |
| Healthstar | $153 | 467% |
| First Health | $153 | 467% |
| Sagamore Health Network | $153 | 467% |
| Preferred Health Network | $153 | 467% |
| Employer's Coalition on Health | $157 | 480% |
| Security Health Plan | $157 | 480% |
| Swedish American | $157 | 480% |
| Beech Street | $157 | 480% |
| Private Health Care System | $157 | 480% |
| Benchmark Health | $157 | 480% |
| Wellmark/Healthnetwork | $160 | 489% |
| National Provider Network | $165 | 504% |
| Integrated Health Plan | $165 | 504% |
| Health Smart | $165 | 504% |
| Multiplan | $165 | 504% |
| Wea Insurance Group | $165 | 504% |
| Unicare | $3,678 - $8,500 | 11237% |