CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $47
Cash Discount Price: $51
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Larkin Community Hospital Palm Springs Campus is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.44x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $51 (156%)

Insurance Median: $47 (144%)

Cash: $51 (156% of Medicare)

Ins. Median: $47 (144% 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.

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
Cigna	$18	55%
Aetna	$22 - $34	67%
Florida Community Care Mcaid-All Plans	$22	67%
Humana	$22 - $73	67%
Miami Childrens Hp Mcaid-All Plans	$22	67%
Sunshine Mcaid	$22	67%
Wellcare Mcaid	$22	67%
Medicare (plans)	$32 - $73	98%
Ambetter / Centene	$34	104%
Blue Cross Blue Shield	$34 - $258	104%
Opus Hospice Ip Only - All Plans	$34	104%
Clear Springs Health - All Plans	$36	110%
Unicare Simply Mcare Ppo - All Plans	$36	110%
Wellcare Comm (Choice) - All Other Plans	$36	110%
Bright Health Commercial - All Other Plans	$41	125%
Ccs - All Plans	$46	141%
Fdc - All Plans	$47	144%
Leon Med Center Mcr Adv - All Plans	$66	202%
Careplus Health - All Other Plans	$73	223%
Centurion Doc - All Plans	$73	223%
Doctors Healthcare - All Plans	$73	223%
Florida Health Solution/Hmo - All Plans	$73	223%
Preferred Care Partners Mcr - All Plans	$73	223%
Simply Healthcare Mcr - All Other Plans	$73	223%
UnitedHealthcare	$73 - $100	223%
Naphcare - All Plans	$84	257%
Simply Healthcare Mcaid	$100	306%
United Mcaid	$100	306%
Oscar Health-All Plans	$146	446%

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 $51.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

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 97112.
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.