CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Community Memorial Hospital - Ventura

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $38
Cash Discount Price: $233
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Community Memorial Hospital - Ventura is $38. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $233. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.13x the Medicare baseline. Located in 147 North Brent Street, Ventura, CA.

Cash / Self-Pay

$233

Average discount available for prompt cash payment at this facility.

Insurance Median

$38

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: $233 (691%)

Insurance Median: $38 (113%)

Cash: $233 (691% of Medicare)

Ins. Median: $38 (113% 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
Medi-Cal	$16	47%
Non Contracted	$16 - $37	47%
Medicaid / KanCare	$24 - $136	71%
Gold Coast Health Plan	$25 - $136	74%
Aetna	$27 - $380	80%
Blue Cross Blue Shield	$37 - $50	110%
California Workers Compensation	$37	110%
Medicare (plans)	$37 - $38	110%
Seaview	$37	110%
Tricare	$37	110%
Wellcare Of California	$37	110%
Alignment Health Plan	$38	113%
Humana	$38	113%
Scan Health Plan	$38	113%
UnitedHealthcare	$38 - $420	113%
Valley Care	$48 - $97	142%
Ventura County Health Care Plan	$97	288%
Multiplan	$233	691%
Cigna	$290	860%
Health Net Commercial	$389	1153%
Kaiser Commercial	$528	1565%
Blue Shield Epn	$578	1714%
Blue Shield Commercial	$626	1856%

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 $233.
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 Community Memorial Hospital - Ventura 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.