CMS Price Transparency Data
Physical therapy (manual therapy)
Facility: Palmetto General Hospital
Billing Code: 97140 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97140
- Insurance Median: $55
- Cash Discount Price: $446
- vs. Medicare Baseline: 1.98x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Palmetto General Hospital is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $446. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.98x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$446
Average discount available for prompt cash payment at this facility.
Insurance Median
$55
Median negotiated contract rate across all mapped commercial carriers.
Medicare Reference Rate
$27.72
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $446 (1609%)
Insurance Median: $55 (198%)
Cash: $446 (1609% of Medicare)
Ins. Median: $55 (198% of Medicare)
Understanding this gauge: We use the federal Medicare rate of $27.72 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 | $13 - $317 | 47% |
| Veterans Administration Mill Bill | $19 | 69% |
| Medicare (plans) | $25 - $446 | 90% |
| Humana | $27 - $75 | 97% |
| Leon Health Inc | $27 | 97% |
| Tricare | $27 | 97% |
| Bristol Hospice- Miami Dade Llc | $28 | 101% |
| Catholic Hospice | $28 | 101% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $28 | 101% |
| Devoted Health | $28 | 101% |
| Employer Direct Healthcare | $28 - $35 | 101% |
| Hospice Other | $28 | 101% |
| Ima Evalutations Inc | $28 | 101% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $28 | 101% |
| Opuscare Of South Fl | $28 | 101% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $28 | 101% |
| Select Specialty Hospital | $28 | 101% |
| UnitedHealthcare | $28 - $362 | 101% |
| Veterans Administration Vaccn | $28 | 101% |
| Vitas Healthcare Hospice | $28 | 101% |
| Westchester General Hospital | $28 | 101% |
| Cigna | $29 - $223 | 105% |
| Healthsun Health Plans | $29 | 105% |
| Longevity Health Plan | $29 | 105% |
| Florida Pace Centers | $33 | 119% |
| Bright Health Management Commercial | $34 | 123% |
| Dimension Health Wc | $34 | 123% |
| Self Pay/Uninsured | $34 | 123% |
| Workers Compensation | $34 | 123% |
| Naphcare Inc | $39 | 141% |
| Avmed Exchange | $49 | 177% |
| Ambetter / Centene | $52 | 188% |
| Molina Marketplace Program Exchange | $53 | 191% |
| Auto Insurance | $56 | 202% |
| Avmed Select Network | $57 | 206% |
| Amerihealth Caritas Next Exchange | $60 | 216% |
| Bc/Bs Myblue Hmo Hix | $68 | 245% |
| Bc/Bs Of Fl Health Options Hmo | $68 | 245% |
| Bc/Bs Of Fl Network Blue | $68 | 245% |
| Bc/Bs Of Fl Simplyblue | $68 | 245% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $72 | 260% |
| Bc/Bs Of Fl Ppo | $76 | 274% |
| Bc/Bs Of Fl Miami Dade Blue Select | $90 | 325% |
| Medicaid / KanCare | $111 - $446 | 400% |
| Oscar Health Plan Hix | $114 | 411% |
| Imagine Health | $161 | 581% |
| Avmed Broad Network | $174 | 628% |
| Liga Contra El Cancer | $223 | 804% |
| Bc/Bs Of Fl Phs | $224 | 808% |
| Magellan Behavioral Health | $267 | 963% |
| Dimensions International | $290 | 1046% |
| First Health | $299 | 1079% |
| Dimension Health Ppo | $334 | 1205% |
| Beacon Health Strategies Commercial | $446 | 1609% |
| Commercial Non-Contracted | $446 | 1609% |
| Self Pay - Mcd Pending 100 Percent | $446 | 1609% |
| Single Case Agreement | $446 | 1609% |
| United Behavioral Health Psych | $446 | 1609% |