CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: HCA Florida North Florida Hospital

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $29
  • Cash Discount Price: $393
  • vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at HCA Florida North Florida Hospital is $29. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $393. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.05x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$393

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
$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)
Cash / Self-Pay: $393 (1418%)
Insurance Median: $29 (105%)
Cash: $393 (1418% of Medicare)
Ins. Median: $29 (105% 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
Hospice Of North Central Fl $22 - $25 79%
Humana $24 - $79 87%
Ndms Definitive Care $24 - $27 87%
United $24 - $177 87%
United Behavioral Health $24 - $27 87%
Wellmed $24 - $27 87%
Aetna $25 - $118 90%
American Health Plan $25 - $29 90%
Blue Cross Blue Shield $25 - $28 90%
Capital Health Plan $25 - $28 90%
Sunshine State $25 - $29 90%
Wellcare $25 - $29 90%
Align Senior Care $26 - $29 94%
Centurion $26 - $30 94%
Cigna $26 - $164 94%
Clear Spring Health $26 - $30 94%
Florida Complete Care $26 - $29 94%
Gold Kidney Of Florida $26 - $30 94%
Ultimate Health Plan $28 - $31 101%
Corvel Corporation $29 105%
Longevity Health Plan $29 - $33 105%
Prime Health $30 108%
Careworks (Rockport Community) $31 112%
Avmed $47 - $197 170%
Oscar $47 170%
Simply Healthcare $50 180%
Molina Healthcare $75 - $126 271%
Evolutions $90 325%
Sunshine State Health Plan $100 361%
Plotkin Health $197 711%
Prime Health Sheriff $197 711%
Corizon Phs $236 851%
Multiplan $307 - $334 1108%
Evernorth $315 1136%
Evolutions Healthcare $334 1205%
Ppo Next $334 1205%
Novanet $354 1277%
Beacon Health Options $393 1418%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6500 W Newberry Rd, Gainesville, FL 32605
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals