CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $36
  • Cash Discount Price: $802
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Central Florida Lake Monroe Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $802. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$802

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
$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $802 (2378%)
Insurance Median: $36 (107%)
Cash: $802 (2378% of Medicare)
Ins. Median: $36 (107% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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
Devoted Health $29 - $33 86%
Humana $29 - $160 86%
Ndms Definitive Care $29 - $33 86%
United $29 - $361 86%
Wellmed $29 - $33 86%
Aetna $30 - $241 89%
Blue Cross Blue Shield $30 - $34 89%
Fl Health Care Plan $30 - $34 89%
Align Senior Care $31 - $35 92%
American Health Plan $31 - $35 92%
Avmed $31 - $401 92%
Cigna $31 - $140 92%
Florida Complete Care $31 - $35 92%
Sunshine State $31 - $35 92%
Wellcare $31 - $35 92%
Centurion $32 - $36 95%
Clear Spring Health $32 - $36 95%
Gold Kidney Of Florida $32 - $36 95%
Seminole County Sheriffs Office $32 - $36 95%
Careplus $33 - $38 98%
Ultimate Health Plan $33 - $38 98%
Longevity Health Plan $35 - $40 104%
Solis Health Plan $42 - $48 125%
Freedom Health $58 172%
Optimum $58 172%
Oscar $128 379%
Simply Healthcare $134 397%
Molina Healthcare $152 - $257 451%
Evolutions $184 546%
Sunshine State Health Plan $205 608%
Florida Health Care Plan $302 895%
Plotkin Health $401 1189%
Prime Health Sheriff $401 1189%
Multiplan $602 - $682 1785%
Three Rivers Provider Network $602 1785%
Ppo Next $682 2022%
Novanet $722 2141%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals