CMS Price Transparency Data
Physical therapy (neuromuscular re-education)
Facility: Palmetto General Hospital
Billing Code: 97112 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97112
- Insurance Median: $63
- Cash Discount Price: $416
- vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at Palmetto General Hospital is $63. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $416. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.92x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$416
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: $416 (1271%)
Insurance Median: $63 (192%)
Cash: $416 (1271% 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 | $12 - $296 | 37% |
| Veterans Administration Mill Bill | $23 | 70% |
| Medicare (plans) | $29 - $416 | 89% |
| Humana | $31 - $75 | 95% |
| Devoted Health | $32 | 98% |
| Leon Health Inc | $32 | 98% |
| UnitedHealthcare | $32 - $362 | 98% |
| Bristol Hospice- Miami Dade Llc | $33 | 101% |
| Catholic Hospice | $33 | 101% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $33 | 101% |
| Employer Direct Healthcare | $33 - $41 | 101% |
| Hospice Other | $33 | 101% |
| Ima Evalutations Inc | $33 | 101% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $33 | 101% |
| Opuscare Of South Fl | $33 | 101% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $33 | 101% |
| Select Specialty Hospital | $33 | 101% |
| Veterans Administration Vaccn | $33 | 101% |
| Vitas Healthcare Hospice | $33 | 101% |
| Westchester General Hospital | $33 | 101% |
| Cigna | $34 - $208 | 104% |
| Healthsun Health Plans | $34 | 104% |
| Tricare | $34 | 104% |
| Longevity Health Plan | $35 | 107% |
| 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% |
| Avmed Exchange | $58 | 177% |
| Ambetter / Centene | $61 | 186% |
| Molina Marketplace Program Exchange | $63 | 192% |
| Bc/Bs Myblue Hmo Hix | $64 | 196% |
| Bc/Bs Of Fl Health Options Hmo | $64 | 196% |
| Bc/Bs Of Fl Network Blue | $64 | 196% |
| Bc/Bs Of Fl Simplyblue | $64 | 196% |
| Auto Insurance | $66 | 202% |
| Avmed Select Network | $67 | 205% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $68 | 208% |
| Amerihealth Caritas Next Exchange | $71 | 217% |
| Bc/Bs Of Fl Ppo | $71 | 217% |
| Bc/Bs Of Fl Miami Dade Blue Select | $84 | 257% |
| Medicaid / KanCare | $104 - $416 | 318% |
| Oscar Health Plan Hix | $114 | 348% |
| Imagine Health | $161 | 492% |
| Avmed Broad Network | $174 | 532% |
| Liga Contra El Cancer | $208 | 636% |
| Bc/Bs Of Fl Phs | $209 | 639% |
| Magellan Behavioral Health | $250 | 764% |
| Dimensions International | $271 | 828% |
| First Health | $279 | 852% |
| Dimension Health Ppo | $312 | 953% |
| Beacon Health Strategies Commercial | $416 | 1271% |
| Commercial Non-Contracted | $416 | 1271% |
| Self Pay - Mcd Pending 100 Percent | $416 | 1271% |
| Single Case Agreement | $416 | 1271% |
| United Behavioral Health Psych | $416 | 1271% |