CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: HCA Florida Twin Cities Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $34
Cash Discount Price: $136
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at HCA Florida Twin Cities Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.01x the Medicare baseline. Located in 2190 Hwy 85 N, Niceville, FL.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)

Cash / Self-Pay: $136 (403%)

Insurance Median: $34 (101%)

Cash: $136 (403% of Medicare)

Ins. Median: $34 (101% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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
Oscar	$18	53%
Simply Healthcare	$23	68%
Cigna	$24 - $56	71%
Molina Healthcare	$26 - $44	77%
Humana	$29 - $52	86%
Ndms Definitive Care	$29 - $33	86%
Regency Hospice	$29 - $33	86%
United	$29 - $61	86%
Wellmed	$29 - $33	86%
Aetna	$30 - $55	89%
Blue Cross Blue Shield	$30 - $34	89%
American Health Plan	$31 - $35	92%
Florida Complete Care	$31 - $35	92%
Healthspring Of Florida	$31 - $35	92%
Sunshine State	$31 - $35	92%
Wellcare	$31 - $35	92%
Centurion	$32 - $36	95%
Clear Spring Health	$32 - $36	95%
Gold Kidney Of Florida	$32 - $36	95%
Avmed	$33 - $68	98%
Ultimate Health Plan	$33 - $38	98%
Longevity Health Plan	$35 - $40	104%
Sunshine State Health Plan	$35	104%
Plotkin Health	$68	202%
Prime Health Sheriff	$68	202%
Evolutions Healthcare	$88 - $116	261%
Multiplan	$106 - $116	314%
Ppo Next	$116	344%
Novanet	$122	362%

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 $136.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Twin Cities Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
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.