CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $46
  • Cash Discount Price: $287
  • vs. Medicare Baseline: 1.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Central Florida Lake Monroe Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.41x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
$287

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $287 (877%)
Insurance Median: $46 (141%)
Cash: $287 (877% of Medicare)
Ins. Median: $46 (141% 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.

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
Freedom Health $20 - $21 61%
Optimum $20 - $21 61%
Devoted Health $28 - $32 86%
Humana $28 - $129 86%
Ndms Definitive Care $28 - $32 86%
United $28 - $130 86%
Wellmed $28 - $32 86%
Aetna $29 - $87 89%
Blue Cross Blue Shield $29 - $33 89%
Fl Health Care Plan $29 - $33 89%
Align Senior Care $30 - $34 92%
American Health Plan $30 - $34 92%
Avmed $30 - $145 92%
Cigna $30 - $50 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%
Seminole County Sheriffs Office $31 - $35 95%
Careplus $32 - $37 98%
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%
Solis Health Plan $41 - $47 125%
Oscar $45 - $46 137%
Simply Healthcare $47 - $48 144%
Molina Healthcare $54 - $93 165%
Evolutions $65 - $67 199%
Sunshine State Health Plan $72 - $74 220%
Florida Health Care Plan $107 - $109 327%
Plotkin Health $142 - $145 434%
Prime Health Sheriff $142 - $145 434%
Multiplan $213 - $246 651%
Three Rivers Provider Network $213 - $218 651%
Ppo Next $242 - $246 739%
Novanet $256 - $261 782%

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