CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Shands Jacksonville

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $163
  • Cash Discount Price: $197
  • vs. Medicare Baseline: 5.61x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Shands Jacksonville is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $197. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.61x the Medicare baseline. Located in 655 W 8Th St, Jacksonville, FL.
Cash / Self-Pay
$197

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$29.06

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $29.06 (100%)
Cash / Self-Pay: $197 (678%)
Insurance Median: $163 (561%)
Cash: $197 (678% of Medicare)
Ins. Median: $163 (561% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $29.06 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 561% of the Medicare baseline (a markup of 461%). 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
Carelon Health $24 83%
Humana $24 - $304 83%
Aetna $25 - $295 86%
Florida Community Care $25 86%
Amerihealth Caritas Florida $26 89%
Community Care Plan $26 89%
Molina $26 - $48 89%
Simply Healthcare $27 93%
Ameri-Plus Preferred Care $37 127%
Blue Cross Blue Shield $37 - $196 127%
Capital Health Plan $37 - $179 127%
Beacon Health Strategies $38 131%
Florida Health Care Plan $38 - $67 131%
Devoted Health Plan $39 - $41 134%
UnitedHealthcare $39 - $269 134%
Positive Healthcare Partners $41 141%
Wellcare Of Florida $44 151%
Florida Complete Care $47 162%
Ambetter / Centene $62 213%
Volusia Health Network $150 516%
Northeast Florida State Hospital $157 540%
Careplus Health Plan $161 554%
Avmed $163 - $173 561%
North Florida Evaluation & Treatment Center $168 578%
Cigna $176 606%
Wellpath $179 616%
Centivo $197 678%
Disney Cruise Line $215 740%
Health First Health Plan $233 - $250 802%
Mental Health Associates $233 802%
Prime Health Services $250 - $268 860%
Florida Health Alliance $258 888%
Archbold Medical Center $268 922%
Genex $268 922%
Rockport Provider $268 922%
Corvel Corp $304 1046%
First Health $304 1046%
Florida Hospital Healthcare System $304 1046%
Medsave Usa Tpa $304 1046%
Fringe Benefits Coordinators $322 - $340 1108%
Multiplan $322 1108%
Novanet $322 1108%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 655 W 8Th St, Jacksonville, FL 32209
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals