CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Adventist Health Reedley

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $57
Cash Discount Price: $36
vs. Medicare Baseline: 1.69x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Adventist Health Reedley is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $36. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.69x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$36

Average discount available for prompt cash payment at this facility.

Insurance Median

$57

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: $36 (107%)

Insurance Median: $57 (169%)

Cash: $36 (107% of Medicare)

Ins. Median: $57 (169% 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.

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
Cal Viva Hlth Mcal - All Plans	$16	47%
Kern Health Systems Mcal-All Plans	$16	47%
Medi-Cal	$16	47%
Dignity Mcal Op/Profee Only-All Other Plans	$18	53%
Community Care Ipa Mcal-All Plans	$21	62%
Bc Mcal	$22	65%
Healthnet Medi-Cal	$28	83%
Blue Shield Mcare	$36	107%
Dignity Mcr Adv Op/Profee Only	$36	107%
Fhcn Pace Mcr Adv-All Plans	$36	107%
Healthnet- Mcr Adv	$36	107%
Kaiser Mcr Adv	$36	107%
Phs Prime Health Srvcs	$36	107%
Tricare	$36	107%
UnitedHealthcare	$36 - $301	107%
Bright Health Mcr Adv - All Plans	$56	166%
Aetna	$59 - $390	175%
Ah Employee Health Plan - All Plans	$64	190%
Healthnet- All Other Plans	$83	246%
Western Growers/Pinnacle- All Plans	$87	258%
Kaiser - All Other Plans	$95	282%
Blue Shield Epn - All Other Plans	$103	305%
Blue Shield Non Epn	$119	353%
Cigna	$124	368%
Physicians Med Group Op/Profee Only- All Plans	$152	451%
Blue Cross Blue Shield	$393 - $526	1165%

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 $36.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Reedley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
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.