CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: Coral Gables Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $63
  • Cash Discount Price: $388
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Coral Gables Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $388. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$388

Average discount available for prompt cash payment at this facility.

Insurance Median
$63

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: $388 (1185%)
Insurance Median: $63 (192%)
Cash: $388 (1185% of Medicare)
Ins. Median: $63 (192% 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
Aetna $11 - $308 34%
Veterans Administration Mill Bill $23 70%
Medicare (plans) $29 - $71 89%
Humana $31 - $75 95%
Devoted Health $32 98%
Leon Health Inc $32 98%
UnitedHealthcare $32 - $328 98%
Catholic Hospice $33 101%
Employer Direct Healthcare $33 - $41 101%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $33 101%
Hospice Other $33 101%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $33 101%
Opus Care Of South Florida $33 101%
Seasons Hospice And Palliative Care Of Southern Florida Inc $33 101%
Veterans Administration Vaccn $33 101%
Vitas Healthcare Corporation/Hospice Ppo $33 101%
Cigna $34 - $121 104%
Healthsun Health Plans $34 104%
Longevity Health Plan $34 104%
Tricare $34 104%
Dimension Health Wc $39 119%
Florida Pace Centers $39 119%
Workers Compensation $39 119%
Bright Health Management Commercial $40 122%
Self Pay/Uninsured $40 122%
Naphcare Inc $45 137%
Bc/Bs Myblue Hmo Hix $56 - $63 171%
Bc/Bs Of Fl Health Options Hmo $56 - $63 171%
Bc/Bs Of Fl Miami Dade Blue Select $56 - $63 171%
Bc/Bs Of Fl Network Blue $56 - $63 171%
Bc/Bs Of Fl Ppo $56 - $63 171%
Bc/Bs Of Fl Simplyblue $56 - $63 171%
Avmed Exchange $58 177%
Bc/Bs Of Fl Blue Select Exchange Non Par $59 - $67 180%
Ambetter / Centene $61 186%
Molina Marketplace Program Exchange $63 192%
Auto Insurance $66 202%
Avmed Select Network $67 205%
Amerihealth Caritas Next Exchange $71 217%
Medicaid / KanCare $91 - $103 278%
Oscar Health Plan Hix $114 348%
Imagine Health $161 492%
Avmed Broad Network $175 535%
Bc/Bs Of Fl Phs $196 - $221 599%
Dimension International $237 - $267 724%
First Health $259 - $292 791%
Dimension Health Ppo $274 - $308 837%
Commercial Non-Contracted $365 - $411 1115%
Self Pay - Mcd Pending 100 Percent $365 - $411 1115%
Single Case Agreement $365 - $411 1115%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3100 Douglas Rd, Coral Gables, FL 33134
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals