CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Loma Linda University Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $132
Cash Discount Price: $83
vs. Medicare Baseline: 3.91x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Loma Linda University Medical Center is $132. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $83. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.91x the Medicare baseline. Located in 11234 Anderson St, Loma Linda, CA.

Cash / Self-Pay

$83

Average discount available for prompt cash payment at this facility.

Insurance Median

$132

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: $83 (246%)

Insurance Median: $132 (391%)

Cash: $83 (246% of Medicare)

Ins. Median: $132 (391% 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 391% of the Medicare baseline (a markup of 291%). 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
Inland Empire Health Plan (Iehp)	$20	59%
Kaiser Foundation Hospitals	$22 - $123	65%
Adventist Health	$37 - $75	110%
Lluh Dept Of Risk Management	$37 - $75	110%
Epic Health Plan	$74	219%
Riverside University Health System	$74	219%
Alpha Care Medical Group	$101 - $156	299%
Global Benefits Group	$110	326%
Temecula Valley Physicians Medical Group	$110	326%
Trivalley Medical Group	$110	326%
Aetna	$112	332%
Cigna	$118 - $136	350%
Networks By Design	$120	356%
Molina Healthcare Of Ca	$129	382%
Multiplan	$138	409%
Central Health Plan	$147	436%
Dignity Health	$156	462%
Galaxy Health	$156	462%
Prime Health Services	$156	462%
Vantage Medical Group	$156	462%
Health Management Network	$166	492%
UnitedHealthcare	$206 - $417	611%
Blue Shield Of California	$268 - $412	795%
Blue Cross Blue Shield	$336 - $447	996%

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 $83.
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 Loma Linda University 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.