CMS Price Transparency Data

Physical therapy (neuromuscular re-education)

Facility: HCA Florida Poinciana Hospital

Billing Code: 97112 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97112
Insurance Median: $34
Cash Discount Price: $1,012
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Physical therapy (neuromuscular re-education) at HCA Florida Poinciana Hospital is $34. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,012. Compared to the federal Medicare reimbursement reference rate of $32.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.

Cash / Self-Pay

$1,012

Average discount available for prompt cash payment at this facility.

Insurance Median

$34

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: $1,012 (3092%)

Insurance Median: $34 (104%)

Cash: $1,012 (3092% of Medicare)

Ins. Median: $34 (104% 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.

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
Devoted Health	$28 - $32	86%
Humana	$28 - $283	86%
Ndms Definitive Care	$28 - $32	86%
United	$28 - $456	86%
Wellmed	$28 - $32	86%
Aetna	$29 - $304	89%
Blue Cross Blue Shield	$29 - $33	89%
Fl Health Care Plan	$29 - $33	89%
Align Senior Care	$30 - $34	92%
American Health Plan	$30 - $34	92%
Avmed	$30 - $506	92%
Cigna	$30 - $176	92%
Florida Complete Care	$30 - $34	92%
Sunshine State	$30 - $34	92%
Wellcare	$30 - $34	92%
Centurion	$31 - $35	95%
Clear Spring Health	$31 - $35	95%
Gold Kidney Of Florida	$31 - $35	95%
Careplus	$32 - $37	98%
Ultimate Health Plan	$33 - $37	101%
Longevity Health Plan	$34 - $39	104%
Corvel Corporation	$37	113%
Prime Health	$38	116%
Careworks (Rockport Community)	$39	119%
Solis Health Plan	$41 - $47	125%
Freedom Health	$73	223%
Optimum	$73	223%
Oscar	$162	495%
Simply Healthcare	$169	516%
Molina Healthcare	$192 - $273	587%
Evolutions	$233	712%
Sunshine State Health Plan	$258	788%
Plotkin Health	$506	1546%
Prime Health Sheriff	$506	1546%
Multiplan	$759 - $860	2319%

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 $1,012.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97112.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Poinciana Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97112.
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.