CMS Price Transparency Data

Physical therapy (gait training)

Facility: HCA Florida South Shore Hospital

Billing Code: 97116 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97116
  • Insurance Median: $31
  • Cash Discount Price: $344
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (gait training) at HCA Florida South Shore Hospital is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $344. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.07x the Medicare baseline. Located in 4016 Sun City Center Blvd, Sun City Center, FL.
Cash / Self-Pay
$344

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: $344 (1184%)
Insurance Median: $31 (107%)
Cash: $344 (1184% 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
Access 2 Healthcare Physicians Freedom Optimum Group Members $14 - $18 48%
Access 2 Healthcare Physicians Freedom Health $22 - $28 76%
Access 2 Healthcare Physicians Optimum $22 - $28 76%
Avmed $24 - $96 83%
Freedom Health Care $24 - $30 83%
Optimum Healthcare $24 - $30 83%
Aetna $25 - $115 86%
Devoted Health $25 - $29 86%
Ndms Definitive Care $25 - $29 86%
United $25 - $173 86%
United Va Ccn $25 - $29 86%
Wellmed $25 - $29 86%
Baycare Health Plans $26 - $30 89%
Blue Cross Blue Shield $26 - $29 89%
Humana $26 - $108 89%
Sunshine State $26 - $30 89%
Ultimate Health Plan $26 - $29 89%
Wellcare $26 - $30 89%
Align Senior Care $27 - $31 93%
American Health Plan $27 - $30 93%
Cigna $27 - $69 93%
Florida Complete Care $27 - $31 93%
Gold Kidney Of Florida $27 - $31 93%
Rockport Healthcare Group $27 93%
Secur $27 - $31 93%
Caresource $28 96%
Centurion $28 - $31 96%
Clear Spring Health $28 - $31 96%
Careplus $29 - $33 100%
Longevity Health Plan $30 - $34 103%
Corvel Corporation $32 110%
Prime Health $33 114%
Solis Health Plan $37 - $42 127%
Simply Healthcare $39 - $59 134%
Oscar $46 - $58 158%
Molina $58 - $104 200%
Evolutions Healthcare Systems $70 - $354 241%
Sunshine State Health Plan $77 - $98 265%
Plotkin Health $152 - $192 523%
Prime Health Sheriff $152 - $192 523%
Multiplan $228 - $327 785%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4016 Sun City Center Blvd, Sun City Center, FL 33573
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals