CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Fort Walton-Destin Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $89
  • Cash Discount Price: $539
  • vs. Medicare Baseline: 2.72x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Fort Walton-Destin Hospital is $89. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $539. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.72x the Medicare baseline. Located in 1000 Mar-Walt Dr, Fort Walton Beach, FL.
Cash / Self-Pay
$539

Average discount available for prompt cash payment at this facility.

Insurance Median
$89

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: $539 (1647%)
Insurance Median: $89 (272%)
Cash: $539 (1647% of Medicare)
Ins. Median: $89 (272% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 272% of the Medicare baseline (a markup of 172%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $28 - $223 86%
Ndms Definitive Care $28 - $32 86%
Triwest Healthcare Alliance $28 - $32 86%
United $28 - $264 86%
United Behavioral Health $28 - $32 86%
Veterans Evaluation Services $28 - $32 86%
Wellmed $28 - $32 86%
Aetna $29 - $176 89%
Blue Cross Blue Shield $29 - $33 89%
Align Senior Care $30 - $34 92%
American Health Plan $30 - $34 92%
Florida Complete Care $30 - $34 92%
Healthspring Of Florida $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%
Oscar $64 - $76 196%
Simply Healthcare $82 - $98 251%
Cigna $85 - $244 260%
Molina Healthcare $93 - $188 284%
Avmed $118 - $294 361%
Sunshine State Health Plan $125 - $150 382%
Plotkin Health $246 - $294 752%
Prime Health Sheriff $246 - $294 752%
Evolutions Healthcare $319 - $529 975%
Naphcare $319 - $382 975%
Multiplan $383 - $499 1170%
Evernorth $393 - $470 1201%
Ppo Next $417 - $499 1274%
Novanet $442 - $529 1350%
Beacon Health Options $491 - $587 1500%

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