CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: HCA Florida Palms West Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $182
  • Cash Discount Price: $1,126
  • vs. Medicare Baseline: 5.40x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at HCA Florida Palms West Hospital is $182. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,126. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 5.40x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$1,126

Average discount available for prompt cash payment at this facility.

Insurance Median
$182

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $1,126 (3338%)
Insurance Median: $182 (540%)
Cash: $1,126 (3338% of Medicare)
Ins. Median: $182 (540% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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 540% of the Medicare baseline (a markup of 440%). 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 Sfl $30 - $34 89%
Devoted Health $30 - $34 89%
Humana $30 - $401 89%
Ndms Definitive Care $30 - $34 89%
United $30 - $531 89%
Veterans Evaluation Services $30 - $34 89%
Wellmed $30 - $34 89%
Aetna $31 - $354 92%
Blue Cross Blue Shield $31 - $35 92%
Align $32 - $37 95%
American Health Plan $32 - $36 95%
Cigna $32 - $248 95%
Florida Complete Care $32 - $37 95%
Oscar $32 - $189 95%
Prominence Healthfirst $32 - $36 95%
Sunshine State $32 - $38 95%
Centurion $33 - $38 98%
Doctors Healthcare Plan $33 - $38 98%
Gold Kidney $34 - $38 101%
Amerihealth Caritas $36 - $200 107%
Longevity Health Plan $36 - $41 107%
Solis Health Plan $44 - $50 130%
Freedom Health $92 - $189 273%
Optimum $92 - $101 273%
Avmed $139 - $590 412%
Simply Healthcare Plans $139 - $153 412%
Simply Healthcare $145 - $159 430%
Molina $204 - $318 605%
Health Sun Health Plan $228 - $251 676%
Aids Healthcare $236 - $1,415 700%
Mmm Of Fl (Health Advantage Plan) $247 - $271 732%
United Ppo $254 - $279 753%
Sunshine State Health Plan $279 - $307 827%
Health Care District $536 - $590 1589%
Palm Beach Juvenile Correction $536 - $590 1589%
Plotkin Health $536 - $590 1589%
Prime Health Sherriff $536 - $590 1589%
Healthy Palm Beaches $550 1631%
Medica Healthcare $622 - $684 1844%
Multiplan $804 - $1,002 2384%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 13001 Southern Blvd, Loxahatchee, FL 33470
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals