CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $59
Cash Discount Price: $71
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Larkin Community Hospital Palm Springs Campus is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)

Cash / Self-Pay: $71 (210%)

Insurance Median: $59 (175%)

Cash: $71 (210% of Medicare)

Ins. Median: $59 (175% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$22 - $35	65%
Florida Community Care Mcaid-All Plans	$22	65%
Miami Childrens Hp Mcaid-All Plans	$22	65%
Sunshine Mcaid	$22	65%
Wellcare Mcaid	$22	65%
Cigna	$26	77%
Humana	$31 - $102	92%
Medicare (plans)	$33 - $102	98%
Ambetter / Centene	$35	104%
Blue Cross Blue Shield	$35 - $258	104%
Opus Hospice Ip Only - All Plans	$35	104%
Clear Springs Health - All Plans	$37	110%
Unicare Simply Mcare Ppo - All Plans	$37	110%
Bright Health Commercial - All Other Plans	$42	125%
Ccs - All Plans	$47	139%
Fdc - All Plans	$49	145%
Wellcare Comm (Choice) - All Other Plans	$51	151%
Leon Med Center Mcr Adv - All Plans	$92	273%
Simply Healthcare Mcaid	$100	296%
United Mcaid	$100	296%
UnitedHealthcare	$100 - $102	296%
Careplus Health - All Other Plans	$102	302%
Centurion Doc - All Plans	$102	302%
Doctors Healthcare - All Plans	$102	302%
Florida Health Solution/Hmo - All Plans	$102	302%
Preferred Care Partners Mcr - All Plans	$102	302%
Simply Healthcare Mcr - All Other Plans	$102	302%
Naphcare - All Plans	$117	347%
Oscar Health-All Plans	$204	605%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $71.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Larkin Community Hospital Palm Springs Campus is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.