CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Hialeah Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $39
  • Cash Discount Price: $590
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Hialeah Hospital is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $590. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.34x the Medicare baseline. Located in 651 E 25Th St, Hialeah, FL.
Cash / Self-Pay
$590

Average discount available for prompt cash payment at this facility.

Insurance Median
$39

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: $590 (2030%)
Insurance Median: $39 (134%)
Cash: $590 (2030% of Medicare)
Ins. Median: $39 (134% 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.

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 $18 - $425 62%
Veterans Administration Mill Bill $20 69%
Medicare (plans) $26 - $64 89%
Humana $28 - $75 96%
Devoted Health $29 100%
Leon Health Inc $29 100%
Tricare $29 100%
UnitedHealthcare $29 - $355 100%
Bristol Hospice- Miami Dade Llc $30 103%
Catholic Hospice $30 103%
Comprehensive Home Health Care Dba Opuscare Of South Florida $30 103%
Employer Direct Healthcare $30 - $37 103%
Hcr Manor Care Services Of Fl $30 103%
Hospice Other $30 103%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $30 103%
Seasons Hospice And Pallative Care Of Southern Florida Inc $30 103%
Veterans Administration Vaccn $30 103%
Vitas Healthcare Hospice Corporation Of Fl $30 103%
Vitas Hospice Unit Agreement $30 103%
Cigna $31 - $173 107%
Healthsun Health Plans $31 107%
Longevity Health Plan $31 107%
Florida Pace Centers $35 120%
Bright Health Management Commercial $36 124%
Self Pay/Uninsured $36 124%
Dimension Health Wc $37 127%
Workers Compensation $37 127%
Naphcare Inc $41 141%
Avmed Exchange $52 179%
Ambetter / Centene $55 189%
Molina Marketplace Program Exchange $56 193%
Auto Insurance $59 203%
Avmed Select Network $61 210%
Amerihealth Caritas Next Exchange $64 220%
Bc/Bs Myblue Hmo Hix $78 268%
Bc/Bs Of Fl Health Options Hmo $85 292%
Bc/Bs Of Fl Simplyblue $85 292%
Bc/Bs Of Fl Miami Dade Blue Select $90 310%
Bc/Bs Of Fl Network Blue $90 310%
Bc/Bs Of Fl Ppo $90 310%
Bc/Bs Of Fl Blue Select Exchange Non Par $96 330%
Oscar Health Plan Hix $114 392%
Medicaid / KanCare $147 506%
Imagine Health $161 554%
Avmed Broad Network $163 561%
Bc/Bs Of Fl Phs $306 1053%
Dimensions International $383 1318%
First Health $401 1380%
Dimension Health Ppo $442 1521%
Commercial Non-Contracted $590 2030%
Self Pay - Mcd Pending 100 Percent $590 2030%
Single Case Agreement $590 2030%

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