CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Sharp Chula Vista Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $113
Cash Discount Price: $135
vs. Medicare Baseline: 3.35x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Sharp Chula Vista Medical Center is $113. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $135. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.35x the Medicare baseline. Located in 751 Medical Center Court, Chula Vista, CA.

Cash / Self-Pay

$135

Average discount available for prompt cash payment at this facility.

Insurance Median

$113

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: $135 (400%)

Insurance Median: $113 (335%)

Cash: $135 (400% of Medicare)

Ins. Median: $113 (335% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 335% of the Medicare baseline (a markup of 235%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Multiplan	$11 - $135	33%
Epic Americas	$25	74%
Aetna	$27 - $144	80%
County Medical Services	$27 - $148	80%
Health Net	$27 - $4,624	80%
Humana	$27 - $90	80%
Blue Cross Blue Shield	$50 - $28,520	148%
Blue Shield	$50 - $939	148%
Indian Health Council	$53 - $113	157%
Cigna	$61 - $9,248	181%
Interplan	$61 - $255	181%
Molina	$61 - $170	181%
UnitedHealthcare	$61 - $124	181%
Community Health Group	$72 - $86	213%
Kaiser	$108 - $162	320%
California Health And Wellness	$114	338%
Allianz Global Assistance	$121	359%
San Diego Pace	$122 - $124	362%
Medi-Cal	$124 - $162	368%
Medicare (plans)	$126 - $135	374%
Managed Health Network	$162	480%

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 $135.
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 Sharp Chula Vista Medical Center 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.