CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Lake City Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $66
  • Cash Discount Price: $532
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Lake City Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $532. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.
Cash / Self-Pay
$532

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $532 (1625%)
Insurance Median: $66 (202%)
Cash: $532 (1625% of Medicare)
Ins. Median: $66 (202% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 202% of the Medicare baseline (a markup of 102%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Hospice Of North Central Fl $26 - $29 79%
Humana $28 - $110 86%
Ndms Definitive Care $28 - $32 86%
United $28 - $247 86%
Wellmed $28 - $32 86%
Aetna $29 - $165 89%
Blue Cross Blue Shield $29 - $33 89%
Align Senior Care $30 - $34 92%
American Health Plan $30 - $34 92%
Cigna $30 - $229 92%
Florida Complete Care $30 - $34 92%
Sunshine State $30 - $34 92%
Wellcare $30 - $34 92%
Centurion $31 - $35 95%
Clear Spring Health $31 - $35 95%
Gold Kidney Of Florida $31 - $35 95%
Ultimate Health Plan $33 - $37 101%
Longevity Health Plan $34 - $39 104%
Corvel Corporation $37 113%
Prime Health $38 116%
Careworks (Rockport Community) $39 119%
Avmed $62 - $275 189%
Oscar $62 - $66 189%
Simply Healthcare $65 - $70 199%
Evolutions $118 - $467 361%
Sunshine State Health Plan $131 - $140 400%
Molina Healthcare $164 - $176 501%
Plotkin Health $257 - $275 785%
Prime Health Sheriff $257 - $275 785%
Hamilton County Jail $277 - $297 846%
Multiplan $401 - $467 1225%
Ppo Next $437 - $467 1335%
Novanet $462 - $495 1412%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 340 Nw Commerce Dr, Lake City, FL 32055
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals