CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Pasadena Hospital A Part of HCA Florid

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97116
Insurance Median: $58
Cash Discount Price: $240
vs. Medicare Baseline: 2.00x Medicare

The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Pasadena Hospital A Part of HCA Florid is $58. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 2.00x the Medicare baseline. Located in 1501 Pasadena Ave S, Saint Petersburg, FL.

Cash / Self-Pay

$240

Average discount available for prompt cash payment at this facility.

Insurance Median

$58

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: $240 (826%)

Insurance Median: $58 (200%)

Cash: $240 (826% of Medicare)

Ins. Median: $58 (200% 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.

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
Access 2 Healthcare Physicians Freedom Optimum Group Members	$11 - $21	38%
Blue Cross Blue Shield	$11 - $21	38%
Aetna	$16 - $134	55%
Access 2 Healthcare Physicians Freedom Health	$17 - $32	58%
Access 2 Healthcare Physicians Optimum	$17 - $32	58%
Avmed	$19 - $112	65%
Freedom Health Care	$19 - $35	65%
Optimum Healthcare	$19 - $35	65%
Humana	$27 - $125	93%
Rockport Healthcare Group	$27	93%
Simply Healthcare	$30 - $69	103%
Corvel Corporation	$32	110%
Prime Health	$33	114%
Oscar	$36 - $67	124%
United	$39 - $201	134%
Cigna	$43 - $80	148%
Molina	$45 - $121	155%
Evolutions Healthcare Systems	$55 - $411	189%
Sunshine State Health Plan	$61 - $114	210%
Plotkin Health	$119 - $223	409%
Prime Health Sheriff	$119 - $223	409%
Multiplan	$179 - $380	616%

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 $240.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97116.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Pasadena Hospital A Part of HCA Florid is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97116.
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.