CMS Price Transparency Data

Physical therapy (therapeutic exercise)

Facility: Viera Hospital

Billing Code: 97110 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97110
Insurance Median: $179
Cash Discount Price: $56
vs. Medicare Baseline: 6.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (therapeutic exercise) at Viera Hospital is $179. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $56. Compared to the federal Medicare reimbursement reference rate of $29.06, this hospital’s rate is 6.16x the Medicare baseline. Located in 8745 N Wickham Rd, Melbourne, FL.

Cash / Self-Pay

$56

Average discount available for prompt cash payment at this facility.

Insurance Median

$179

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: $56 (193%)

Insurance Median: $179 (616%)

Cash: $56 (193% of Medicare)

Ins. Median: $179 (616% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 616% of the Medicare baseline (a markup of 516%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health First Health Plan	$22 - $67	76%
Corizon Health	$29	100%
UnitedHealthcare	$66 - $561	227%
Florida Healthcare Plans	$71	244%
Cigna	$86 - $92	296%
Aetna	$125 - $247	430%
Disney Cruise Line	$135	465%
Prime Heath Services, Inc.	$168	578%
Multiplan	$179	616%
Amerigroup	$224	771%
Humana	$224	771%
Molina Healthcare	$224 - $251	771%
Sunshine Health Plan	$235	809%
Florida Blue	$1,010 - $1,051	3476%

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 $56.
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 Viera 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.