CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Memorial Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $348
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Memorial Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $348. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 3625 University Blvd S, Jacksonville, FL.
Cash / Self-Pay
$348

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: $348 (1198%)
Insurance Median: $32 (110%)
Cash: $348 (1198% 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
Optimum Healthcare $15 - $43 52%
Hospice Community $20 - $23 69%
Avmed $22 - $144 76%
Hospice Haven $23 - $26 79%
Simply Healthcare $23 - $79 79%
United $23 - $232 79%
Aetna $25 - $155 86%
Careplus $25 - $29 86%
Devoted Health $25 - $29 86%
Humana $25 - $150 86%
Ndms Definitive Care $25 - $29 86%
United Behavioral Health $25 - $29 86%
Veterans Evaluation Services $25 - $29 86%
Wellmed $25 - $29 86%
Blue Cross Blue Shield $26 - $29 89%
Sunshine State $26 - $30 89%
Wellcare $26 - $30 89%
American Health Plan $27 - $30 93%
Cigna $27 - $146 93%
Florida Complete Care $27 - $31 93%
Gold Kidney $27 - $31 93%
Oscar $29 - $83 100%
Longevity $30 - $34 103%
City Of Jacksonville $32 110%
Corvel Corporation $32 110%
Prime Health $33 114%
Positive Healthcare $40 - $114 138%
Sunshine State Health Plan $46 - $132 158%
Molina Healthcare $49 - $139 169%
Centurion $50 - $143 172%
Corizon $54 - $155 186%
Plotkin Health $90 - $258 310%
Multiplan $140 - $439 482%
Evernorth $144 - $413 496%
Evolutions Healthcare $144 - $439 496%
Ppo Next $153 - $439 526%
Novanet $162 - $464 557%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3625 University Blvd S, Jacksonville, FL 32216
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals