CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Lawnwood Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $66
  • Cash Discount Price: $426
  • vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Lawnwood Hospital is $66. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $426. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 1700 S 23Rd St, Fort Pierce, FL.
Cash / Self-Pay
$426

Average discount available for prompt cash payment at this facility.

Insurance Median
$66

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: $426 (1302%)
Insurance Median: $66 (202%)
Cash: $426 (1302% of Medicare)
Ins. Median: $66 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Careplus $29 - $33 89%
Devoted Health $29 - $34 89%
Humana $29 - $172 89%
Ndms Definitive Care $29 - $33 89%
United $29 - $285 89%
United Behavioral Health $29 - $33 89%
Veterans Evaluation Services $29 - $33 89%
Wellmed $29 - $33 89%
Aetna $30 - $335 92%
Blue Cross Blue Shield $30 - $469 92%
Bright Health $30 - $190 92%
Cigna $30 - $406 92%
Innovage Pace $30 - $35 92%
Kaiser $30 - $225 92%
Mutual Of Omaha $30 - $34 92%
Rocky Mountain Health $30 - $34 92%
Total Longterm Care $30 - $34 92%
Triwest Health Alliance $30 - $34 92%
Ultimate Health Plan $30 - $34 92%
American Health Plan $31 - $35 95%
Delaware Life Insurance $31 - $36 95%
Florida Complete Care $31 - $36 95%
Freedom Health $31 - $69 95%
Optimum $31 - $37 95%
Prominence Healthfirst $31 - $35 95%
Sunshine State $31 - $37 95%
Wellcare $31 - $35 95%
Centurion $32 - $37 98%
Amerihealth Caritas $35 - $40 107%
Longevity Health Plan $35 - $40 107%
Corvel Corporation $38 116%
Careworks (Rockport) $39 119%
Prime Health $39 - $570 119%
Solis Health Plan $42 - $48 128%
Avmed $47 - $214 144%
Simply Healthcare Plans $47 - $56 144%
Vail Health $64 - $96 196%
Molina $69 - $116 211%
Oscar $69 - $82 211%
Health Sun Health Plan $78 - $91 238%
Simply Healthcare $86 - $101 263%
Sunshine State Health Plan $93 - $109 284%
Office Of Sheiff Highland Co $128 - $150 391%
United Ppo $161 - $189 492%
Plotkin Health $182 - $214 556%
Prime Health Sherriff $182 - $214 556%
Multiplan $274 - $570 837%
Western Plains Community Health $275 - $412 840%
Evernorth Bh $292 - $343 892%
Northcare $296 - $444 904%
Physician Health Partners $296 - $444 904%
Pinnacol Workers Comp $317 - $475 969%
Medical Development International $338 - $507 1033%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1700 S 23Rd St, Fort Pierce, FL 34950
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals