CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Jfk Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $435
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Jfk Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $435. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 5301 S Congress Ave, Atlantis, FL.
Cash / Self-Pay
$435

Average discount available for prompt cash payment at this facility.

Insurance Median
$32

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: $435 (1497%)
Insurance Median: $32 (110%)
Cash: $435 (1497% of Medicare)
Ins. Median: $32 (110% 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
Palm Beach Pace $25 - $28 86%
Blue Cross Blue Shield $26 - $30 89%
Careplus Sfl $26 - $30 89%
Devoted Health $26 - $30 89%
Humana $26 - $148 89%
Ndms Definitive Care $26 - $30 89%
United $26 - $196 89%
United Behavioral Health $26 - $30 89%
Veterans Evaluation Services $26 - $30 89%
Wellmed $26 - $30 89%
Aetna $27 - $130 93%
Oscar $27 - $70 93%
Prominence Healthfirst $27 - $31 93%
Sunshine State $27 - $32 93%
Align $28 - $32 96%
American Health Plan $28 - $31 96%
Cigna $28 - $91 96%
Florida Complete Care $28 - $32 96%
Centurion $29 - $32 100%
Doctors Healthcare Plan $29 - $32 100%
Gold Kidney $29 - $33 100%
Amerihealth Caritas $31 - $74 107%
Longevity Health Plan $31 - $35 107%
Corvel Corporation $33 114%
Careworks (Rockport) $34 117%
Prime Health $34 117%
Freedom Health $37 - $70 127%
Optimum $37 127%
Solis Health Plan $38 - $43 131%
Avmed $57 - $218 196%
Simply Healthcare Plans $57 196%
Simply Healthcare $59 203%
Molina $74 - $117 255%
Health Sun Health Plan $93 320%
Aids Healthcare $96 - $522 330%
Mmm Of Fl (Health Advantage Plan) $100 344%
United Ppo $103 354%
Sunshine State Health Plan $113 389%
Blis $152 523%
District Cares $218 750%
Plotkin Health $218 750%
Prime Health Sherriff $218 750%
Medica Healthcare $257 884%
Multiplan $326 - $370 1122%
Evernorth Bh $348 1198%
Healthy Palm Beaches $550 1893%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5301 S Congress Ave, Atlantis, FL 33462
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals