CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Larkin Community Hospital Palm Springs Campus

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $100
  • Cash Discount Price: $161
  • vs. Medicare Baseline: 3.44x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Larkin Community Hospital Palm Springs Campus is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $161. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.44x the Medicare baseline. Located in 1475 W 49Th St, Hialeah, FL.
Cash / Self-Pay
$161

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $161 (554%)
Insurance Median: $100 (344%)
Cash: $161 (554% of Medicare)
Ins. Median: $100 (344% 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 344% of the Medicare baseline (a markup of 244%). 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 - $30 76%
Florida Community Care Mcaid-All Plans $22 76%
Miami Childrens Hp Mcaid-All Plans $22 76%
Sunshine Mcaid $22 76%
Wellcare Mcaid $22 76%
Medicare (plans) $29 - $230 100%
Ambetter / Centene $30 103%
Blue Cross Blue Shield $30 - $258 103%
Opus Hospice Ip Only - All Plans $30 103%
Clear Springs Health - All Plans $32 110%
Unicare Simply Mcare Ppo - All Plans $32 110%
Bright Health Commercial - All Other Plans $36 124%
Ccs - All Plans $41 141%
Fdc - All Plans $42 145%
Cigna $58 200%
Humana $69 - $230 237%
Simply Healthcare Mcaid $100 344%
United Mcaid $100 344%
UnitedHealthcare $100 - $230 344%
Wellcare Comm (Choice) - All Other Plans $115 396%
Leon Med Center Mcr Adv - All Plans $207 712%
Careplus Health - All Other Plans $230 791%
Centurion Doc - All Plans $230 791%
Doctors Healthcare - All Plans $230 791%
Florida Health Solution/Hmo - All Plans $230 791%
Preferred Care Partners Mcr - All Plans $230 791%
Simply Healthcare Mcr - All Other Plans $230 791%
Naphcare - All Plans $264 908%
Oscar Health-All Plans $460 1583%

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