CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: PAM Rehabilitation Hospital of Tavares LLC

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97140
Insurance Median: $55
Cash Discount Price: $127
vs. Medicare Baseline: 1.98x Medicare

The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at PAM Rehabilitation Hospital of Tavares LLC is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 1.98x the Medicare baseline. Located in 1730 Mayo Dr, Tavares, FL.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$55

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$27.72

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $27.72 (100%)

Cash / Self-Pay: $127 (458%)

Insurance Median: $55 (198%)

Cash: $127 (458% of Medicare)

Ins. Median: $55 (198% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $27.72 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
Aetna	$17 - $27	61%
Curative	$20	72%
Careplus	$25	90%
UnitedHealthcare	$25 - $75	90%
Humana	$26	94%
Palm Beach Aco Reach	$26	94%
Primary Care Alliance	$26	94%
Blue Cross Blue Shield	$27 - $64	97%
Ilumed Aco Reach	$27	97%
Simply Healthcare	$27	97%
Sunshine State Health Plan	$27	97%
Wellmed	$27	97%
Velocity Provider Ppo Network	$32 - $96	115%
Prime Health Services	$35 - $108	126%
America'S Choice Provider Network	$89	321%
Quik Trip	$96	346%
Usa Managed Care Organization	$96	346%
Multiplan/Phcs	$102	368%
Orlando Health Network	$135	487%

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 $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97140.

Insurance In-Network Protection Plan

Contact your insurance company to confirm PAM Rehabilitation Hospital of Tavares LLC is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97140.
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.