CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Adventist Health Lodi Memorial

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $57
  • Cash Discount Price: $12
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Adventist Health Lodi Memorial is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $12. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.69x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.
Cash / Self-Pay
$12

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: $12 (36%)
Insurance Median: $57 (169%)
Cash: $12 (36% 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.

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
Kaiser Mcal $16 47%
Medi-Cal $16 47%
Celtic Ins Company - All Plans $18 53%
Hp Of San Joaquin Mcal $21 62%
Bc Mcal $23 68%
Healthnet Mcal $24 71%
Alignment Health Plan (Ahp)-All Plans $36 107%
Blue Shield Mcare Adv $36 107%
Cca Health Plan Mcr Adv- All Plans $36 107%
Healthnet Mcare $36 107%
Hp Of San Joaquin Mcr Adv $36 107%
Humana $36 107%
Kaiser Mcr Adv $36 107%
Tricare $36 107%
UnitedHealthcare $36 - $203 107%
Knnex Health - All Plans $43 127%
Medcore(Omni Ipa) Op Only- All Plans $44 130%
Blue Shield Epn - All Other Plans $55 163%
Blue Shield Non-Epn $57 169%
Ah Employee Health Plan - All Plans $64 190%
Aetna $69 205%
Kaiser Commercial - All Other Plans $70 208%
Bright Health - All Plans $71 210%
Healthnet- All Other Plans $83 246%
Networks By Design- All Plans $85 252%
Multiplan- All Plans $136 403%
First Health- All Plans $139 412%
Beech Street- All Plans $153 454%
Cigna $153 454%
Three Rivers Provider Network- All Plans $153 454%
Hp Of San Joaquin Ppo - All Other Plans $162 480%
Western Growers- All Plans $435 1290%
Blue Cross Blue Shield $445 - $499 1319%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 975 S Fairmont Avenue, Lodi, CA 95240
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals