CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Orange Park Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $42
  • Cash Discount Price: $537
  • vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Orange Park Hospital is $42. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $537. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.28x the Medicare baseline. Located in 2001 Kingsley Ave, Orange Park, FL.
Cash / Self-Pay
$537

Average discount available for prompt cash payment at this facility.

Insurance Median
$42

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: $537 (1641%)
Insurance Median: $42 (128%)
Cash: $537 (1641% of Medicare)
Ins. Median: $42 (128% 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 Community $23 - $26 70%
Hospice Haven $26 - $29 79%
Careplus $28 - $32 86%
Devoted Health $28 - $32 86%
Humana $28 - $298 86%
Ndms Definitive Care $28 - $32 86%
United $28 - $328 86%
United Behavioral Health $28 - $32 86%
Veterans Evaluation Services $28 - $32 86%
Wellmed $28 - $32 86%
Blue Cross Blue Shield $29 - $33 89%
Optimum Healthcare $29 - $61 89%
American Health Plan $30 - $34 92%
Cigna $30 - $206 92%
Florida Complete Care $30 - $34 92%
Sunshine State $30 - $34 92%
Wellcare $30 - $34 92%
Gold Kidney $31 - $35 95%
Longevity $34 - $39 104%
Clay County Sheriffs Office $35 - $40 107%
Corvel Corporation $37 113%
Prime Health $38 116%
Avmed $42 - $204 128%
Simply Healthcare $44 - $112 134%
Oscar $56 - $116 171%
Positive Healthcare $76 - $160 232%
Sunshine State Health Plan $88 - $186 269%
Molina Healthcare $94 - $197 287%
Aetna $104 - $218 318%
Medicare (plans) $156 - $328 477%
Plotkin Health $174 - $364 532%
Multiplan $271 - $619 828%
Evernorth $278 - $582 849%
Evolutions Healthcare $278 - $619 849%
Ppo Next $295 - $619 901%
Novanet $312 - $655 953%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2001 Kingsley Ave, Orange Park, FL 32073
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals