CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $191
  • Cash Discount Price: $208
  • vs. Medicare Baseline: 6.89x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Larkin Community Hospital Palm Springs Campus is $191. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $208. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 6.89x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$208

Average discount available for prompt cash payment at this facility.

Insurance Median
$191

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $208 (750%)
Insurance Median: $191 (689%)
Cash: $208 (750% of Medicare)
Ins. Median: $191 (689% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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 689% of the Medicare baseline (a markup of 589%). 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
Aetna $22 - $29 79%
Florida Community Care Mcaid-All Plans $22 79%
Miami Childrens Hp Mcaid-All Plans $22 79%
Sunshine Mcaid $22 79%
Wellcare Mcaid $22 79%
Medicare (plans) $27 - $301 97%
Ambetter / Centene $29 105%
Blue Cross Blue Shield $29 - $258 105%
Opus Hospice Ip Only - All Plans $29 105%
Clear Springs Health - All Plans $30 108%
Unicare Simply Mcare Ppo - All Plans $30 108%
Bright Health Commercial - All Other Plans $35 126%
Ccs - All Plans $39 141%
Fdc - All Plans $40 144%
Cigna $74 - $75 267%
Humana $88 - $301 317%
Simply Healthcare Mcaid $100 361%
United Mcaid $100 361%
UnitedHealthcare $100 - $301 361%
Wellcare Comm (Choice) - All Other Plans $147 - $150 530%
Leon Med Center Mcr Adv - All Plans $265 - $271 956%
Careplus Health - All Other Plans $294 - $301 1061%
Centurion Doc - All Plans $294 - $301 1061%
Doctors Healthcare - All Plans $294 - $301 1061%
Florida Health Solution/Hmo - All Plans $294 - $301 1061%
Preferred Care Partners Mcr - All Plans $294 - $301 1061%
Simply Healthcare Mcr - All Other Plans $294 - $301 1061%
Naphcare - All Plans $338 - $346 1219%
Oscar Health-All Plans $588 - $602 2121%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1475 W 49Th St, Hialeah, FL 33012
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals