CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Aventura Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $496
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Aventura Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $496. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 20900 Biscayne Blvd, Aventura, FL.
Cash / Self-Pay
$496

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: $496 (1707%)
Insurance Median: $32 (110%)
Cash: $496 (1707% 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
Humana $26 - $169 89%
Aetna $27 - $149 93%
Blue Cross Blue Shield $27 - $31 93%
Careplus Sfl $27 - $30 93%
Cigna $27 - $104 93%
Devoted Health $27 - $30 93%
Leon Health $27 - $30 93%
Ndms Definitive Care $27 - $30 93%
United $27 - $223 93%
United Behavioral Health $27 - $30 93%
Veterans Evaluation Services $27 - $30 93%
Wellmed $27 - $30 93%
Align $28 - $32 96%
American Health Plan $28 - $32 96%
Florida Complete Care $28 - $32 96%
Oscar $28 - $79 96%
Prominence Healthfirst $28 - $32 96%
Sunshine State $28 - $33 96%
Avmed $29 - $248 100%
Centurion $29 - $33 100%
Doctors Healthcare Plan $29 - $33 100%
Gold Kidney $30 - $34 103%
Amerihealth Caritas $32 - $84 110%
Longevity Health Plan $32 - $36 110%
Corvel Corporation $34 117%
Careworks (Rockport) $35 120%
Prime Health $35 120%
Solis Health Plan $38 - $44 131%
Freedom Health $43 - $79 148%
Optimum $43 148%
Simply Healthcare Plans $64 220%
Simply Healthcare $67 231%
Molina $84 - $134 289%
Health Sun Health Plan $106 365%
Aids Healthcare $109 - $595 375%
Mmm Of Fl (Health Advantage Plan) $114 392%
United Ppo $118 406%
Sunshine State Health Plan $129 444%
Plotkin Health $248 853%
Prime Health Sherriff $248 853%
Medica Healthcare $288 991%
Multiplan $372 - $422 1280%
Evernorth Bh $397 1366%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 20900 Biscayne Blvd, Aventura, FL 33180
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals