CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Adventist Health Delano

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $59
Cash Discount Price: $27
vs. Medicare Baseline: 1.75x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Adventist Health Delano is $59. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $27. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.75x the Medicare baseline. Located in 1401 Garces Highway, Delano, CA.

Cash / Self-Pay

$27

Average discount available for prompt cash payment at this facility.

Insurance Median

$59

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: $27 (80%)

Insurance Median: $59 (175%)

Cash: $27 (80% of Medicare)

Ins. Median: $59 (175% 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
Dignty Hlth Mcal Op Only	$16	47%
Kaiser Medi-Cal Ip/Op Only	$16	47%
Medi-Cal	$16	47%
Universal Care Mcal	$16	47%
Blue Cross Blue Shield	$19 - $112	56%
Healthnet Medi-Cal	$20	59%
Kern Health System Mcal	$21	62%
Blue Shield Epn - All Other Plans	$29	86%
Bakersfield Fam Med Grp-All Plans	$36	107%
Healthnet Mcr Adv	$36	107%
Kern Mcr Adv Dual Dnsp-All Other Plans	$36	107%
Medicare (plans)	$36 - $57	107%
Tricare	$36	107%
UnitedHealthcare	$36 - $96	107%
Universal Care Mcr- All Other Plans	$36	107%
Kaiser Comm Ip/Op Only- All Other Plans	$61	181%
Ah Employee Health Plan - All Plans	$64	190%
Healthnet- All Other Plans	$71	210%
Centivo - All Plans	$80	237%
Coventry- All Plans	$80	237%
County Of Kern Network - All Plans	$94	279%
Gem Care- All Plans	$94	279%
Aetna	$99	294%
Foundation For Medical Care Of Kern County - All P	$100	296%
Cigna	$107	317%
Western Growers - All Plans	$109	323%
Blue Shield Non-Epn	$262	777%

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 $27.
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 Adventist Health Delano 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.