CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Coral Gables Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $100
  • Cash Discount Price: $727
  • vs. Medicare Baseline: 3.44x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Coral Gables Hospital is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $727. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 3.44x the Medicare baseline. Located in 3100 Douglas Rd, Coral Gables, FL.
Cash / Self-Pay
$727

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $727 (2502%)
Insurance Median: $100 (344%)
Cash: $727 (2502% of Medicare)
Ins. Median: $100 (344% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 344% of the Medicare baseline (a markup of 244%). 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.

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 $20 - $598 69%
Veterans Administration Mill Bill $20 69%
Medicare (plans) $26 - $64 89%
Humana $28 - $75 96%
Devoted Health $29 100%
Leon Health Inc $29 100%
Tricare $29 100%
UnitedHealthcare $29 - $328 100%
Catholic Hospice $30 103%
Employer Direct Healthcare $30 - $37 103%
Hcr Manor Care Services Of Fl Ii Dba Heartland Hospice Services $30 103%
Hospice Other $30 103%
Odyssey Healthcare Of Marion County Dba Kindred Hospice $30 103%
Opus Care Of South Florida $30 103%
Seasons Hospice And Palliative Care Of Southern Florida Inc $30 103%
Veterans Administration Vaccn $30 103%
Vitas Healthcare Corporation/Hospice Ppo $30 103%
Cigna $31 - $234 107%
Healthsun Health Plans $31 107%
Longevity Health Plan $31 107%
Florida Pace Centers $35 120%
Bright Health Management Commercial $36 124%
Self Pay/Uninsured $36 124%
Dimension Health Wc $37 127%
Workers Compensation $37 127%
Naphcare Inc $41 141%
Avmed Exchange $52 179%
Ambetter / Centene $55 189%
Molina Marketplace Program Exchange $56 193%
Auto Insurance $59 203%
Avmed Select Network $61 210%
Amerihealth Caritas Next Exchange $64 220%
Bc/Bs Myblue Hmo Hix $100 - $122 344%
Bc/Bs Of Fl Health Options Hmo $100 - $122 344%
Bc/Bs Of Fl Miami Dade Blue Select $100 - $122 344%
Bc/Bs Of Fl Network Blue $100 - $122 344%
Bc/Bs Of Fl Ppo $100 - $122 344%
Bc/Bs Of Fl Simplyblue $100 - $122 344%
Bc/Bs Of Fl Blue Select Exchange Non Par $107 - $129 368%
Oscar Health Plan Hix $114 392%
Imagine Health $161 554%
Medicaid / KanCare $164 - $199 564%
Avmed Broad Network $175 602%
Bc/Bs Of Fl Phs $353 - $428 1215%
Dimension International $427 - $518 1469%
First Health $467 - $566 1607%
Dimension Health Ppo $493 - $598 1696%
Commercial Non-Contracted $657 - $797 2261%
Self Pay - Mcd Pending 100 Percent $657 - $797 2261%
Single Case Agreement $657 - $797 2261%

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