CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Holmes Regional Medical Center

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $179
  • Cash Discount Price: $56
  • vs. Medicare Baseline: 5.47x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Holmes Regional Medical Center is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 5.47x the Medicare baseline. Located in 1350 S Hickory St, Melbourne, FL.
Cash / Self-Pay
$56

Average discount available for prompt cash payment at this facility.

Insurance Median
$179

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: $56 (171%)
Insurance Median: $179 (547%)
Cash: $56 (171% of Medicare)
Ins. Median: $179 (547% 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 547% of the Medicare baseline (a markup of 447%). 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
Health First Health Plan $23 - $67 70%
Corizon Health $32 98%
UnitedHealthcare $66 - $561 202%
Florida Healthcare Plans $71 217%
Cigna $86 - $92 263%
Aetna $125 - $247 382%
Disney Cruise Line $135 412%
Prime Heath Services, Inc. $168 513%
Multiplan $179 547%
Humana $224 684%
Molina Healthcare $224 - $251 684%
Amerigroup $235 718%
Sunshine Health Plan $235 718%
Florida Blue $1,010 - $1,051 3086%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1350 S Hickory St, Melbourne, FL 32901
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals