CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Lehigh Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $36
  • Cash Discount Price: $467
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Lehigh Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $467. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 1500 Lee Blvd, Lehigh Acres, FL.
Cash / Self-Pay
$467

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $467 (1427%)
Insurance Median: $36 (110%)
Cash: $467 (1427% of Medicare)
Ins. Median: $36 (110% 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
Freedom Health Care $18 - $36 55%
Optimum Healthcare $18 - $36 55%
Aetna $28 - $140 86%
United $28 - $77 86%
Wellmed $28 - $32 86%
Blue Cross Blue Shield $29 - $33 89%
Simply Healthcare $29 - $72 89%
Humana $30 - $35 92%
Wellcare $30 - $34 92%
Caresource $31 95%
Longevity Health Plan $34 - $39 104%
Oscar $34 - $70 104%
Cigna $39 - $81 119%
Evolutions Healthcare Systems $52 - $429 159%
Sunshine State Health Plan $58 - $119 177%
Plotkin Health $113 - $233 345%

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