CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Ventura County Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $49
  • Cash Discount Price: $154
  • vs. Medicare Baseline: 1.45x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Ventura County Medical Center is $49. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $154. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.45x the Medicare baseline. Located in 300 Hillmont Avenue, Ventura, CA.
Cash / Self-Pay
$154

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: $154 (457%)
Insurance Median: $49 (145%)
Cash: $154 (457% 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
Hpn Ip/Op Only Medi-Cal $16 47%
Kaiser Medi-Cal Ip/Op Only $16 47%
Medi-Cal $16 47%
Kaiser Mcal Pediatric Ip/Op Only $18 53%
Americas Hp Mcal Ip/Op Only $21 62%
Clinicas Mcal $21 62%
Gold Coast Medi-Cal-All Plans $29 86%
Tricare $36 107%
Alignment Hp - All Plans $37 110%
Blue Shield Mcr Adv $37 110%
Humana $37 110%
UnitedHealthcare $38 - $169 113%
Healthnet Mcr Adv $39 116%
Americas Hp Mcr Adv Ip/Op Only $43 127%
Clinicas Mcr Adv $43 127%
Scan-All Plans $45 133%
Western Growers-All Plans $47 139%
Clinicas Comm - All Other Plans $49 145%
Imperial-All Plans $49 145%
Ntwrk Provdrs-All Plans $49 145%
Americas Hp Comm Ip/Op Only-All Other Plans $56 166%
Vchcp-All Plans $59 175%
Blue Shield Epn $120 356%
Cigna $148 439%
Healthnet Comm-All Other Plans $169 501%
Kaiser Comm Pediatric Ip/Op Only $169 501%
Blue Shield Comm - All Other Plans $172 510%
Aetna $179 - $308 531%
Blue Cross Blue Shield $234 694%
Multiplan/Claritev-All Plans $246 729%
Three Rivers Ip/Op Only-All Plans $246 729%
Ppo Next Ip/Op Only-All Plans $277 821%
Kaiser Mcr Pediatric Ip/Op Only $308 913%
Medicare (plans) $308 913%
Hpn Comm Ip/Op Only-All Other Plans $437 1296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 300 Hillmont Avenue, Ventura, CA 93003
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals