CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Hialeah Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $43
  • Cash Discount Price: $351
  • vs. Medicare Baseline: 1.55x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Hialeah Hospital is $43. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $351. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.55x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$351

Average discount available for prompt cash payment at this facility.

Insurance Median
$43

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: $351 (1266%)
Insurance Median: $43 (155%)
Cash: $351 (1266% of Medicare)
Ins. Median: $43 (155% 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.

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 $11 - $253 40%
Veterans Administration Mill Bill $19 69%
Medicare (plans) $25 - $60 90%
Humana $27 - $75 97%
Leon Health Inc $27 97%
Tricare $27 97%
Bristol Hospice- Miami Dade Llc $28 101%
Catholic Hospice $28 101%
Comprehensive Home Health Care Dba Opuscare Of South Florida $28 101%
Devoted Health $28 101%
Employer Direct Healthcare $28 - $35 101%
Hcr Manor Care Services Of Fl $28 101%
Hospice Other $28 101%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $28 101%
Seasons Hospice And Pallative Care Of Southern Florida Inc $28 101%
UnitedHealthcare $28 - $355 101%
Veterans Administration Vaccn $28 101%
Vitas Healthcare Hospice Corporation Of Fl $28 101%
Vitas Hospice Unit Agreement $28 101%
Cigna $29 - $103 105%
Healthsun Health Plans $29 105%
Longevity Health Plan $29 105%
Florida Pace Centers $33 119%
Bright Health Management Commercial $34 123%
Dimension Health Wc $34 123%
Self Pay/Uninsured $34 123%
Workers Compensation $34 123%
Naphcare Inc $39 141%
Bc/Bs Myblue Hmo Hix $47 170%
Avmed Exchange $49 177%
Bc/Bs Of Fl Health Options Hmo $50 180%
Bc/Bs Of Fl Simplyblue $50 180%
Ambetter / Centene $52 188%
Molina Marketplace Program Exchange $53 191%
Bc/Bs Of Fl Miami Dade Blue Select $54 195%
Bc/Bs Of Fl Network Blue $54 195%
Bc/Bs Of Fl Ppo $54 195%
Auto Insurance $56 202%
Avmed Select Network $57 206%
Bc/Bs Of Fl Blue Select Exchange Non Par $57 206%
Amerihealth Caritas Next Exchange $60 216%
Medicaid / KanCare $88 317%
Oscar Health Plan Hix $114 411%
Imagine Health $161 581%
Avmed Broad Network $163 588%
Bc/Bs Of Fl Phs $182 657%
Dimensions International $228 823%
First Health $239 862%
Dimension Health Ppo $263 949%
Commercial Non-Contracted $351 1266%
Self Pay - Mcd Pending 100 Percent $351 1266%
Single Case Agreement $351 1266%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 651 E 25Th St, Hialeah, FL 33013
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals