CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Mercy Hospital Fort Smith
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $46
- Cash Discount Price: $74
- vs. Medicare Baseline: 1.36x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mercy Hospital Fort Smith is $46. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.36x the Medicare baseline. Located in 7301 Rogers Ave, Fort Smith, AR.
Cash / Self-Pay
$74
Average discount available for prompt cash payment at this facility.
Insurance Median
$46
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: $74 (219%)
Insurance Median: $46 (136%)
Cash: $74 (219% of Medicare)
Ins. Median: $46 (136% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Mercy Interfacility [20513] | $25 | 74% |
| Arkansas Department Of Health [20036] | $27 | 80% |
| Medicaid / KanCare | $27 - $44 | 80% |
| Summit Community Care Contracted [320368] | $27 | 80% |
| Summit Community Care [20368] | $27 | 80% |
| Aetna | $28 - $92 | 83% |
| Humana | $28 - $92 | 83% |
| Aither Health Contracted [320449] | $29 - $46 | 86% |
| Edison Health Solutions Contracted [320502] | $29 - $46 | 86% |
| Mercy Benefit Admin Contracted [320251] | $29 - $69 | 86% |
| American Health Advantage Of Mo Mcr [20264] | $30 | 89% |
| Blue Cross Blue Shield | $30 - $39 | 89% |
| Cherokee Nation Health Serv Contracted [320066] | $30 | 89% |
| Cross Timbers Hospice [20098] | $30 | 89% |
| Dept Of Veteran Affairs Contracted [320106] | $30 | 89% |
| Elara Caring Aspire Hospice Contracted [320433] | $30 | 89% |
| Elara Caring Aspire Hospice [20433] | $30 | 89% |
| Globalhealth Contracted [320145] | $30 | 89% |
| Halo Hcr Inc Hospice Contracted [320432] | $30 | 89% |
| Halo Hcr Inc Hospice [20432] | $30 | 89% |
| Independent Health [20197] | $30 | 89% |
| Jordan Valley Senior Care Pace [20515] | $30 | 89% |
| Kindful Hospice Contracted [320434] | $30 | 89% |
| Kindful Hospice [20434] | $30 | 89% |
| Medical Associates Health [20444] | $30 | 89% |
| Medicare (plans) | $30 - $32 | 89% |
| Mercy Hospice Okc [20252] | $30 | 89% |
| Pace Of The Ozarks [20518] | $30 | 89% |
| Provider Partners Health Plans Contracted [320450] | $30 | 89% |
| Qual Choice Contracted [320325] | $30 | 89% |
| Spina Bifida Hlthcare Benefit [20506] | $30 | 89% |
| Tribute Health Plan Mcr [20338] | $30 | 89% |
| Tricare | $30 | 89% |
| UnitedHealthcare | $30 - $186 | 89% |
| Valir Pace [20503] | $30 | 89% |
| Wellfirst Health Mcr [20443] | $30 | 89% |
| Cigna | $32 - $168 | 95% |
| Usable Contracted [320409] | $39 | 116% |
| Ambetter / Centene | $44 | 130% |
| Home State Health Plan Contracted [320187] | $44 | 130% |
| Novasys Contracted [320285] | $44 - $140 | 130% |
| Health Choice Contracted [320166] | $48 | 142% |
| 90 Degree Benefits Contracted [320436] | $56 - $58 | 166% |
| Show-Me Health Administrators Contracted [320483] | $56 - $58 | 166% |
| Arkansas Total Care Contracted [320039] | $62 | 184% |
| Arkansas Total Care [20039] | $62 | 184% |
| Auxiant Contracted [320462] | $68 - $75 | 202% |
| Ebms Contracted [320493] | $68 - $69 | 202% |
| Healthlink Contracted [320179] | $68 - $75 | 202% |
| Imagine 360 Contracted [320494] | $68 - $69 | 202% |
| Municipal Health Plan Contracted [320271] | $68 - $69 | 202% |
| Reflect Health Contracted [320492] | $68 - $69 | 202% |
| Insurance System Inc Contracted [320465] | $73 - $75 | 216% |
| Personify Health Contracted [320051] | $73 - $75 | 216% |
| Preferred Health Plan Contracted [320522] | $73 - $75 | 216% |
| Workers Comp [20426] | $73 - $75 | 216% |
| Ppo Plus Contracted [320310] | $85 - $86 | 252% |
| First Health Contracted [320128] | $87 - $89 | 258% |
| Employers Health Coalition Contracted [320116] | $89 - $90 | 264% |
| Private Health Care Systems Contracted [320320] | $90 - $92 | 267% |
| Private Health Care Systems [20320] | $90 - $92 | 267% |
| Multiplan Contracted [320270] | $96 - $98 | 285% |
| Multiplan [20270] | $96 - $98 | 285% |
| Qual Choice Contracted [320324] | $99 | 294% |
| United Medical Resources Contracted [320454] | $147 - $186 | 436% |