CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Los Robles Hospital & Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $37
Cash Discount Price: $273
vs. Medicare Baseline: 1.10x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Los Robles Hospital & Medical Center is $37. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $273. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.10x the Medicare baseline. Located in 215 W Janss Rd, Thousand Oaks, CA.

Cash / Self-Pay

$273

Average discount available for prompt cash payment at this facility.

Insurance Median

$37

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: $273 (809%)

Insurance Median: $37 (110%)

Cash: $273 (809% of Medicare)

Ins. Median: $37 (110% 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
Brand New Day	$18 - $37	53%
Gold Coast Health Plan	$18	53%
Aetna	$33 - $273	98%
Alignment Health Plan	$33 - $37	98%
Blue Cross Blue Shield	$33 - $37	98%
Central Health Plan	$33 - $37	98%
Clever Care Of Golden State	$33 - $37	98%
Easy Choice Health Plan	$33 - $37	98%
Facey Medical Group	$33 - $49	98%
Humana	$33 - $37	98%
La Care	$33 - $37	98%
Scan Health Plan	$33 - $37	98%
Triwest Healthcare Alliance	$33 - $37	98%
United	$33 - $77	98%
Blue Shield	$34 - $233	101%
Care1St Health Plan	$34 - $38	101%
Health Net	$37 - $111	110%
Corvel Corporation	$38 - $44	113%
Ventura County Foundation	$39 - $246	116%
Medcare Partners	$41	122%
Bright Health	$75	222%
First Health	$186 - $218	551%
Choicecare Network	$191	566%
Multiplan	$218 - $259	646%
Ppo Next	$218	646%
Interplan Corporation	$246	729%

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 $273.
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 Los Robles Hospital & 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.