CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Santa Rosa Medical Center

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $162
  • Cash Discount Price: $293
  • vs. Medicare Baseline: 5.57x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Santa Rosa Medical Center is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $293. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 5.57x the Medicare baseline. Located in 6002 Berryhill Rd, Milton, FL.
Cash / Self-Pay
$293

Average discount available for prompt cash payment at this facility.

Insurance Median
$162

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: $293 (1008%)
Insurance Median: $162 (557%)
Cash: $293 (1008% of Medicare)
Ins. Median: $162 (557% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 557% of the Medicare baseline (a markup of 457%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Fl Community Care $20 - $25 69%
Molina $20 - $25 69%
Medicaid / KanCare $22 - $26 76%
Humana $23 - $28 79%
Wellcare $23 79%
Tricare $27 93%
Aetna $28 - $13,658 96%
Blue Cross Blue Shield $28 - $5,934 96%
Cigna $28 - $3,817 96%
Medicare (plans) $28 96%
Node Champva $28 96%
UnitedHealthcare $28 - $3,276 96%
Veterans Eval Services $28 96%
Hospice Of Nw Fl $29 - $8,444 100%
Node Va $29 100%
Node Wellcare Mcr Adv $30 103%
Geo Group $36 124%
Node Us Dept Of Labor $44 151%
Prime Health Work Comp Fl $48 165%
Florida Workers Compensation $49 169%
Florida State Auto Insurance $57 196%
Ambetter / Centene $68 234%
Oscar $86 296%
Self Pay $192 - $3,884 661%
Prime Health Services $669 - $13,510 2302%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6002 Berryhill Rd, Milton, FL 32570
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals