CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida North Florida Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $34
  • Cash Discount Price: $335
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida North Florida Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $335. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$335

Average discount available for prompt cash payment at this facility.

Insurance Median
$34

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: $335 (1024%)
Insurance Median: $34 (104%)
Cash: $335 (1024% of Medicare)
Ins. Median: $34 (104% 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
Hospice Of North Central Fl $26 - $29 79%
Humana $28 - $67 86%
Ndms Definitive Care $28 - $32 86%
United $28 - $151 86%
United Behavioral Health $28 - $32 86%
Wellmed $28 - $32 86%
Aetna $29 - $100 89%
Blue Cross Blue Shield $29 - $33 89%
Capital Health Plan $29 - $33 89%
Align Senior Care $30 - $34 92%
American Health Plan $30 - $34 92%
Cigna $30 - $139 92%
Florida Complete Care $30 - $34 92%
Sunshine State $30 - $34 92%
Wellcare $30 - $34 92%
Centurion $31 - $35 95%
Clear Spring Health $31 - $35 95%
Gold Kidney Of Florida $31 - $35 95%
Ultimate Health Plan $33 - $37 101%
Longevity Health Plan $34 - $39 104%
Corvel Corporation $37 113%
Prime Health $38 116%
Careworks (Rockport Community) $39 119%
Avmed $40 - $167 122%
Oscar $40 122%
Simply Healthcare $42 128%
Molina Healthcare $64 - $107 196%
Evolutions $77 235%
Sunshine State Health Plan $85 260%
Plotkin Health $167 510%
Prime Health Sheriff $167 510%
Corizon Phs $201 614%
Multiplan $261 - $284 797%
Evernorth $268 819%
Evolutions Healthcare $284 868%
Ppo Next $284 868%
Novanet $301 920%
Beacon Health Options $335 1024%

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