CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Sacred Heart Hospital on the Emerald Coast

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $28
Cash Discount Price: $120
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Sacred Heart Hospital on the Emerald Coast is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 0.96x the Medicare baseline. Located in 7800 Us Hwy 98 W, Miramar Beach, FL.

Cash / Self-Pay

$120

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $120 (413%)

Insurance Median: $28 (96%)

Cash: $120 (413% of Medicare)

Ins. Median: $28 (96% 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
Aarp Mcr Hmo	$28	96%
Blue Mcr Replacement	$28	96%
Facility Billing - Op	$28	96%
Healthspring Mcr Replacement	$28 - $29	96%
Medicare (plans)	$28	96%
Smarthealth	$28	96%
Triwest	$28	96%
UnitedHealthcare	$28	96%
Wellcare	$28	96%
Aetna	$29 - $239	100%
Humana	$29	100%
Oscar Health Plan	$45	155%
Ambetter / Centene	$46	158%
Occunet	$52 - $63	179%

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 $120.
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 Sacred Heart Hospital on the Emerald Coast 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.