CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Trinity Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $29
  • Cash Discount Price: $281
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Trinity Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $281. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.00x the Medicare baseline. Located in 9330 Sr 54, Trinity, FL.
Cash / Self-Pay
$281

Average discount available for prompt cash payment at this facility.

Insurance Median
$29

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: $281 (967%)
Insurance Median: $29 (100%)
Cash: $281 (967% of Medicare)
Ins. Median: $29 (100% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members $13 45%
Access 2 Healthcare Physicians Freedom Health $20 69%
Access 2 Healthcare Physicians Optimum $20 69%
Avmed $22 - $70 76%
Freedom Health Care $22 76%
Optimum Healthcare $22 76%
Aetna $25 - $84 86%
Devoted Health $25 - $29 86%
Hernando-Pasco Hospice $25 - $29 86%
Ndms Definitive Care $25 - $29 86%
Sunshine State $25 - $29 86%
United $25 - $127 86%
United Behavioral Health $25 - $29 86%
United Va Ccn $25 - $29 86%
Wellcare $25 - $29 86%
Wellmed $25 - $29 86%
Baycare Health Plans $26 - $30 89%
Blue Cross Blue Shield $26 - $29 89%
Humana $26 - $79 89%
Ultimate Health Plan $26 - $29 89%
Align Senior Care $27 - $31 93%
American Health Plan $27 - $30 93%
Cigna $27 - $51 93%
Florida Complete Care $27 - $31 93%
Gold Kidney Of Florida $27 - $31 93%
Rockport Healthcare Group $27 93%
Secur $27 - $31 93%
Caresource $28 96%
Centurion $28 - $31 96%
Clear Spring Health $28 - $31 96%
Pasco Sheriff'S Office $28 - $31 96%
Careplus $29 - $33 100%
Longevity Health Plan $30 - $34 103%
Corvel Corporation $32 110%
Prime Health $33 114%
Simply Healthcare $36 - $43 124%
Solis Health Plan $37 - $42 127%
Oscar $42 145%
Molina $53 - $76 182%
Evolutions Healthcare Systems $65 - $259 224%
Sunshine State Health Plan $72 248%
Beacon Health Options $141 485%
Plotkin Health $141 485%
Prime Health Sheriff $141 485%
Multiplan $211 - $239 726%
Evernorth $225 774%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9330 Sr 54, Trinity, FL 34655
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals