CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Riverview Regional Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $49
  • Cash Discount Price: $31
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Riverview Regional Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $31. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.45x the Medicare baseline. Located in 600 South Third Street, Gadsden, AL.
Cash / Self-Pay
$31

Average discount available for prompt cash payment at this facility.

Insurance Median
$49

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)
Cash / Self-Pay: $31 (92%)
Insurance Median: $49 (145%)
Cash: $31 (92% of Medicare)
Ins. Median: $49 (145% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $33.73 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.

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
Medicaid / KanCare $15 44%
Humana $30 89%
Blue Cross Blue Shield $31 - $49 92%
Cigna $31 92%
Evernorth Behavioral Health $31 92%
Health Service Center $31 92%
Medicare (plans) $31 92%
Tricare $31 92%
UnitedHealthcare $31 - $113 92%
Viva Health $31 92%
Devoted Health $32 95%
Simpra Advantage $32 95%
Employer Direct Healthcare $44 130%
Naphcare $48 142%
Occunet $63 - $74 187%
Compone $68 202%
Corvel $70 208%
Novanet $72 213%
Zelis(Fka Stratose) $72 213%
Americas Choice Provider Network $74 219%
Multiplan $74 219%
Prime Health Services $74 219%
Three Rivers $74 219%
Provider Select $75 222%
Provider Network Of America $76 225%
Workers Compensation $76 225%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 South Third Street, Gadsden, AL 35901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals