CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $451
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida Fort Walton-Destin Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $451. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.
Cash / Self-Pay
$451

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

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: $451 (1552%)
Insurance Median: $31 (107%)
Cash: $451 (1552% of Medicare)
Ins. Median: $31 (107% 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
Humana $25 - $171 86%
Ndms Definitive Care $25 - $29 86%
Triwest Healthcare Alliance $25 - $28 86%
United $25 - $203 86%
United Behavioral Health $25 - $29 86%
Veterans Evaluation Services $25 - $29 86%
Wellmed $25 - $29 86%
Aetna $26 - $135 89%
Blue Cross Blue Shield $26 - $29 89%
Sunshine State $26 - $30 89%
Wellcare $26 - $30 89%
Align Senior Care $27 - $31 93%
American Health Plan $27 - $30 93%
Florida Complete Care $27 - $31 93%
Gold Kidney Of Florida $27 - $31 93%
Healthspring 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%
Oscar $59 203%
Simply Healthcare $75 258%
Cigna $78 - $187 268%
Molina Healthcare $86 - $144 296%
Avmed $108 - $225 372%
Sunshine State Health Plan $115 396%
Plotkin Health $225 774%
Prime Health Sheriff $225 774%
Evolutions Healthcare $293 - $406 1008%
Naphcare $293 1008%
Multiplan $352 - $383 1211%
Evernorth $361 1242%
Ppo Next $383 1318%
Novanet $406 1397%
Beacon Health Options $451 1552%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Mar-Walt Dr, Fort Walton Beach, FL 32547
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals