CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: HCA Florida North Florida Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97110
  • Insurance Median: $46
  • Cash Discount Price: $390
  • vs. Medicare Baseline: 1.58x Medicare
The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at HCA Florida North Florida Hospital is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $390. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.58x the Medicare baseline. Located in 6500 W Newberry Rd, Gainesville, FL.
Cash / Self-Pay
$390

Average discount available for prompt cash payment at this facility.

Insurance Median
$46

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: $390 (1342%)
Insurance Median: $46 (158%)
Cash: $390 (1342% of Medicare)
Ins. Median: $46 (158% 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
Hospice Of North Central Fl $23 - $26 79%
Humana $25 - $89 86%
Ndms Definitive Care $25 - $29 86%
United $25 - $200 86%
United Behavioral Health $25 - $29 86%
Wellmed $25 - $29 86%
Aetna $26 - $133 89%
Blue Cross Blue Shield $26 - $29 89%
Capital Health Plan $26 - $29 89%
Sunshine State $26 - $30 89%
Wellcare $26 - $30 89%
Align Senior Care $27 - $31 93%
American Health Plan $27 - $30 93%
Cigna $27 - $185 93%
Florida Complete Care $27 - $31 93%
Gold Kidney Of Florida $27 - $31 93%
Centurion $28 - $31 96%
Clear Spring Health $28 - $31 96%
Ultimate Health Plan $29 - $33 100%
Longevity Health Plan $30 - $34 103%
Corvel Corporation $32 110%
Prime Health $33 114%
Careworks (Rockport Community) $34 117%
Avmed $40 - $222 138%
Oscar $40 - $53 138%
Simply Healthcare $42 - $56 145%
Molina Healthcare $64 - $142 220%
Evolutions $77 - $102 265%
Sunshine State Health Plan $85 - $113 292%
Plotkin Health $167 - $222 575%
Prime Health Sheriff $167 - $222 575%
Corizon Phs $201 - $267 692%
Multiplan $261 - $378 898%
Evernorth $268 - $356 922%
Evolutions Healthcare $284 - $378 977%
Ppo Next $284 - $378 977%
Novanet $301 - $400 1036%
Beacon Health Options $335 - $445 1153%

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