CMS Price Transparency Data

Physical therapy (manual therapy)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 97140 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97140
  • Insurance Median: $248
  • Cash Discount Price: $435
  • vs. Medicare Baseline: 8.95x Medicare
The contracted insurance negotiated median rate for a Physical therapy (manual therapy) at Nemours Childrens Hospital, Florida is $248. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $435. Compared to the federal Medicare reimbursement reference rate of $27.72, this hospital’s rate is 8.95x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$435

Average discount available for prompt cash payment at this facility.

Insurance Median
$248

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: $435 (1569%)
Insurance Median: $248 (895%)
Cash: $435 (1569% of Medicare)
Ins. Median: $248 (895% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 895% of the Medicare baseline (a markup of 795%). 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
Tricare $27 97%
Avmed $135 487%
Employers Health Network Fl $174 628%
Florida Blue $174 - $265 628%
Truli $174 628%
Aetna $191 - $276 689%
Evolutions Healthcare $196 707%
UnitedHealthcare $246 887%
Cigna $248 895%
Integra Administrative Group $261 942%
Global Medical Management $283 1021%
Prime Health Services $283 1021%
Star Healthcare Network $283 1021%
Velocity $326 1176%
First Health Network $339 1223%
Pnoa $348 1255%
Seminole Tribe Of Fl $348 1255%
Private Healthcare Systems $400 1443%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens