CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Palms West Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97112
  • Insurance Median: $140
  • Cash Discount Price: $759
  • vs. Medicare Baseline: 4.28x Medicare
The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Palms West Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $759. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 4.28x the Medicare baseline. Located in 13001 Southern Blvd, Loxahatchee, FL.
Cash / Self-Pay
$759

Average discount available for prompt cash payment at this facility.

Insurance Median
$140

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: $759 (2319%)
Insurance Median: $140 (428%)
Cash: $759 (2319% of Medicare)
Ins. Median: $140 (428% 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 428% of the Medicare baseline (a markup of 328%). 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 $29 - $33 89%
Devoted Health $29 - $33 89%
Humana $29 - $304 89%
Ndms Definitive Care $29 - $33 89%
United $29 - $402 89%
Veterans Evaluation Services $29 - $33 89%
Wellmed $29 - $33 89%
Aetna $30 - $268 92%
Blue Cross Blue Shield $30 - $34 92%
Align $31 - $36 95%
American Health Plan $31 - $35 95%
Cigna $31 - $188 95%
Florida Complete Care $31 - $36 95%
Oscar $31 - $143 95%
Prominence Healthfirst $31 - $35 95%
Sunshine State $31 - $37 95%
Centurion $32 - $37 98%
Doctors Healthcare Plan $32 - $37 98%
Gold Kidney $33 - $37 101%
Amerihealth Caritas $35 - $152 107%
Longevity Health Plan $35 - $40 107%
Corvel Corporation $38 116%
Careworks (Rockport) $39 119%
Prime Health $39 119%
Solis Health Plan $42 - $48 128%
Freedom Health $55 - $143 168%
Optimum $55 - $77 168%
Avmed $83 - $446 254%
Simply Healthcare Plans $83 - $116 254%
Simply Healthcare $86 - $121 263%
Molina $121 - $241 370%
Health Sun Health Plan $136 - $190 416%
Aids Healthcare $140 - $1,072 428%
Mmm Of Fl (Health Advantage Plan) $147 - $205 449%
United Ppo $151 - $212 461%
Sunshine State Health Plan $166 - $232 507%
Health Care District $318 - $446 972%
Palm Beach Juvenile Correction $318 - $446 972%
Plotkin Health $318 - $446 972%
Prime Health Sherriff $318 - $446 972%
Medica Healthcare $369 - $518 1127%
Multiplan $478 - $759 1460%
Healthy Palm Beaches $550 1680%

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