CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $214
  • Cash Discount Price: $422
  • vs. Medicare Baseline: 6.54x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Good Samaritan Hospital of Suffern is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $422. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 6.54x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.
Cash / Self-Pay
$422

Average discount available for prompt cash payment at this facility.

Insurance Median
$214

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: $422 (1289%)
Insurance Median: $214 (654%)
Cash: $422 (1289% of Medicare)
Ins. Median: $214 (654% 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 654% of the Medicare baseline (a markup of 554%). 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
Medicare (plans) $37 - $40 113%
Mvp Gold (McR) $37 113%
Hamaspik (McR) $37 113%
Tricare $37 113%
Affinity By Molina McR $39 119%
Beacon Exchange $44 134%
Beacon Commercial $48 147%
Geisinger Health Commercial/Exchange $122 373%
Self-Pay - Cc 30% $127 388%
Emblem Select Care (Exchange) $163 498%
Emblem Ghi/Hip Hmo/Epo/Pos $192 587%
Emblem Ghi/Hip PPO $192 587%
UnitedHealthcare $193 - $244 590%
Blue Cross Blue Shield $196 - $1,209 599%
Oxford $205 - $222 626%
Oxford Exchange $207 632%
Self-Pay - Cc 50% $211 645%
Cdphp $211 645%
Self-Pay $217 663%
Emblem $230 - $270 703%
Oxford Commercial $238 727%
Mvp $243 - $286 742%
Mvp Exchange $252 770%
Cigna $295 901%
Magnacare Standard $295 901%
Mvp Hmo/Ppo $297 907%
PHCS $316 965%
Multiplan $316 965%
Aetna $339 - $377 1036%
First Health $359 1097%
Magnacare $390 1192%
Magnacare Preferred $413 1262%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 Lafayette Avenue, Suffern, NY 10901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals