CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Northwest Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $32
  • Cash Discount Price: $660
  • vs. Medicare Baseline: 1.10x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Northwest Hospital is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $660. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.10x the Medicare baseline. Located in 2801 N State Rd 7, Margate, FL.
Cash / Self-Pay
$660

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: $660 (2271%)
Insurance Median: $32 (110%)
Cash: $660 (2271% 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
Blue Cross Blue Shield $26 - $30 89%
Careplus Sfl $26 - $30 89%
Devoted Health $26 - $30 89%
Humana $26 - $224 89%
Ndms Definitive Care $26 - $30 89%
United $26 - $297 89%
Veterans Evaluation Services $26 - $30 89%
Wellmed $26 - $30 89%
Aetna $27 - $198 93%
Avmed $27 - $330 93%
Oscar $27 - $106 93%
Prominence Healthfirst $27 - $31 93%
Sunshine State $27 - $32 93%
Align $28 - $32 96%
American Health Plan $28 - $31 96%
Cigna $28 - $139 96%
Florida Complete Care $28 - $32 96%
Centurion $29 - $32 100%
Doctors Healthcare Plan $29 - $32 100%
Gold Kidney $29 - $33 100%
Amerihealth Caritas $31 - $112 107%
Longevity Health Plan $31 - $35 107%
Corvel Corporation $33 114%
Careworks (Rockport) $34 117%
Prime Health $34 117%
Solis Health Plan $38 - $43 131%
Freedom Health $57 - $106 196%
Optimum $57 196%
Simply Healthcare Plans $86 296%
Simply Healthcare $89 306%
Molina $125 - $178 430%
Health Sun Health Plan $141 485%
Mmm Of Fl (Health Advantage Plan) $152 523%
United Ppo $156 537%
Sunshine State Health Plan $174 599%
Blis $231 795%
Plotkin Health $330 1136%
Prime Health Sherriff $330 1136%
Medica Healthcare $383 1318%
Multiplan $495 - $561 1703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2801 N State Rd 7, Margate, FL 33063
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals