CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Hialeah Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $50
  • Cash Discount Price: $407
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Hialeah Hospital is $50. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $407. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.53x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$407

Average discount available for prompt cash payment at this facility.

Insurance Median
$50

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: $407 (1244%)
Insurance Median: $50 (153%)
Cash: $407 (1244% of Medicare)
Ins. Median: $50 (153% 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.

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 $12 - $293 37%
Veterans Administration Mill Bill $23 70%
Medicare (plans) $29 - $71 89%
Humana $31 - $75 95%
Devoted Health $32 98%
Leon Health Inc $32 98%
UnitedHealthcare $32 - $355 98%
Bristol Hospice- Miami Dade Llc $33 101%
Catholic Hospice $33 101%
Comprehensive Home Health Care Dba Opuscare Of South Florida $33 101%
Employer Direct Healthcare $33 - $41 101%
Hcr Manor Care Services Of Fl $33 101%
Hospice Other $33 101%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $33 101%
Seasons Hospice And Pallative Care Of Southern Florida Inc $33 101%
Veterans Administration Vaccn $33 101%
Vitas Healthcare Hospice Corporation Of Fl $33 101%
Vitas Hospice Unit Agreement $33 101%
Cigna $34 - $120 104%
Healthsun Health Plans $34 104%
Longevity Health Plan $34 104%
Tricare $34 104%
Dimension Health Wc $39 119%
Florida Pace Centers $39 119%
Workers Compensation $39 119%
Bright Health Management Commercial $40 122%
Self Pay/Uninsured $40 122%
Naphcare Inc $45 137%
Bc/Bs Myblue Hmo Hix $54 165%
Avmed Exchange $58 177%
Bc/Bs Of Fl Health Options Hmo $58 177%
Bc/Bs Of Fl Simplyblue $58 177%
Ambetter / Centene $61 186%
Bc/Bs Of Fl Miami Dade Blue Select $62 189%
Bc/Bs Of Fl Network Blue $62 189%
Bc/Bs Of Fl Ppo $62 189%
Molina Marketplace Program Exchange $63 192%
Auto Insurance $66 202%
Bc/Bs Of Fl Blue Select Exchange Non Par $66 202%
Avmed Select Network $67 205%
Amerihealth Caritas Next Exchange $71 217%
Medicaid / KanCare $102 312%
Oscar Health Plan Hix $114 348%
Imagine Health $161 492%
Avmed Broad Network $163 498%
Bc/Bs Of Fl Phs $211 645%
Dimensions International $264 807%
First Health $276 843%
Dimension Health Ppo $305 932%
Commercial Non-Contracted $407 1244%
Self Pay - Mcd Pending 100 Percent $407 1244%
Single Case Agreement $407 1244%

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