CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Lehigh Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $29
  • Cash Discount Price: $372
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Lehigh Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $372. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in 1500 Lee Blvd, Lehigh Acres, FL.
Cash / Self-Pay
$372

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $372 (1280%)
Insurance Median: $29 (100%)
Cash: $372 (1280% of Medicare)
Ins. Median: $29 (100% 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 $25 - $112 86%
United $25 - $61 86%
Wellmed $25 - $29 86%
Blue Cross Blue Shield $26 - $29 89%
Humana $26 - $31 89%
Wellcare $27 - $30 93%
Caresource $28 96%
Freedom Health Care $29 100%
Optimum Healthcare $29 100%
Longevity Health Plan $30 - $34 103%
Simply Healthcare $47 - $57 162%
Oscar $56 193%
Cigna $65 224%
Evolutions Healthcare Systems $86 - $342 296%
Sunshine State Health Plan $95 327%
Plotkin Health $186 640%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Lee Blvd, Lehigh Acres, FL 33936
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals