CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Gulf Breeze Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $54
Cash Discount Price: $27
vs. Medicare Baseline: 1.86x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Gulf Breeze Hospital is $54. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 1.86x the Medicare baseline. Located in 1110 Gulf Breeze Pkwy, Gulf Breeze, FL.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$54

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: $27 (93%)

Insurance Median: $54 (186%)

Cash: $27 (93% of Medicare)

Ins. Median: $54 (186% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aetna	$20 - $151	69%
Cha Health Plan	$23	79%
UnitedHealthcare	$23 - $234	79%
Fl Community Care Ltc	$24	83%
Humana	$24 - $38	83%
Sunshine Health	$24	83%
Wellcare	$24 - $39	83%
Simply Healthcare Healthy Kids	$26	89%
Pensacola	$27	93%
Uwf Athletes	$34 - $117	117%
Hospice Covenant	$37	127%
Medicare (plans)	$39	134%
Hospice Regency	$54	186%
Fl Blue	$62 - $308	213%
Cigna	$86 - $180	296%
Hospice Emerald Coast	$90	310%
Private Healthcare	$117	403%
First Health	$125	430%
Wc Corvel	$128 - $171	440%
Choicecare	$135	465%
Multiplan	$160	551%
Bc Fl	$201	692%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $27.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97110.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gulf Breeze Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97110.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.