CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Whittier Hospital Medical Center
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $44
- Cash Discount Price: $13
- vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Whittier Hospital Medical Center is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.30x the Medicare baseline. Located in 9080 Colima Rd, Whittier, CA.
Cash / Self-Pay
$13
Average discount available for prompt cash payment at this facility.
Insurance Median
$44
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: $13 (39%)
Insurance Median: $44 (130%)
Cash: $13 (39% of Medicare)
Ins. Median: $44 (130% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Physician Healthways | $6 - $17 | 18% |
| Blue Cross Blue Shield | $7 - $293 | 21% |
| Physicians Healthways Medical Corporation | $11 | 33% |
| Ahmc Medi-Cal Reciprocity Agreement | $12 | 36% |
| Aids Healthcare Foundation | $12 - $37 | 36% |
| Allied Physicians | $12 - $56 | 36% |
| Alta Med Health Network | $12 - $37 | 36% |
| Altamed Health Services Corporation | $12 | 36% |
| Beverly Hospital | $12 - $41 | 36% |
| Brand New Day | $12 - $46 | 36% |
| Emanate Health | $12 - $46 | 36% |
| Health Net | $12 - $104 | 36% |
| Healthy Way La | $12 | 36% |
| Heritage Provider Network | $12 - $51 | 36% |
| Kaiser Foundation | $12 - $132 | 36% |
| La Care Healthy Families/Healthy Kids | $12 | 36% |
| Non Contracted Medi-Cal | $12 | 36% |
| Prospect Health Plan | $12 - $60 | 36% |
| Synermed | $12 - $38 | 36% |
| La Care Health Plan | $13 - $96 | 39% |
| Avanti | $16 - $45 | 47% |
| Caloptima | $16 - $37 | 47% |
| Care First Health Plan | $16 | 47% |
| County Of Los Angeles Dept Of Health Services | $16 | 47% |
| Hollywood Presbyterian Adv Med Mcal | $16 | 47% |
| Hollywood Presbyterian Medpoint Mcal | $16 | 47% |
| Medi Caid/ Medi Cal | $16 | 47% |
| Monarch Healthplan | $16 | 47% |
| Ahmc Reciprocity | $18 - $52 | 53% |
| Ahmc Reciprocity Agreement Senior/Commercial | $18 - $52 | 53% |
| Wear And Wood | $18 - $70 | 53% |
| Molina Medical Center | $23 - $68 | 68% |
| Central Health Plan Of California | $24 - $70 | 71% |
| Veterans Administration | $26 | 77% |
| UnitedHealthcare | $29 - $267 | 86% |
| Applecare Medical Group | $30 | 89% |
| Blue Shield Of California | $30 - $433 | 89% |
| Aetna | $31 - $127 | 92% |
| Prospect Medical | $33 - $96 | 98% |
| Care 1St Health Plan | $36 - $104 | 107% |
| New Horizon Medical Group Inc | $36 - $104 | 107% |
| Alignment Health Plan | $37 | 110% |
| Alta Los Angeles Hospitals Inc | $37 | 110% |
| Apa/Aco Inc | $37 | 110% |
| Central Health Plan | $37 | 110% |
| Easy Choice Health Plan | $37 | 110% |
| Humana | $37 | 110% |
| Medicare (plans) | $37 - $39 | 110% |
| Pacificare Of California | $37 | 110% |
| Scan Health Plan | $37 | 110% |
| Tricare | $37 | 110% |
| Caremore | $38 | 113% |
| Cov19 Hrsa Uninsured Testing And Treatment Fund | $38 | 113% |
| La Care Covered Direct | $38 | 113% |
| Pacific Alliance Medical Center | $38 | 113% |
| Private Pay | $38 | 113% |
| Self-Pay | $38 | 113% |
| Cost Containment | $39 - $113 | 116% |
| Molina Healthcare Of California | $39 | 116% |
| Universal Care | $39 - $122 | 116% |
| San Miguel Health Plan | $41 | 122% |
| Asi/Flex | $42 - $122 | 125% |
| Us Comp Care | $42 - $122 | 125% |
| Value Healthplan Of California | $42 - $122 | 125% |
| Fmc Los Angeles County | $43 - $130 | 127% |
| Interplan Health Group | $44 | 130% |
| Chinatown Service Center Pace | $45 | 133% |
| Community Care Network | $45 - $130 | 133% |
| Coventry Health Care | $45 - $130 | 133% |
| Coventry Health Care National Network | $45 - $130 | 133% |
| Interplan Corporation | $45 - $130 | 133% |
| Managed Care Administrators | $45 - $130 | 133% |
| Prohealth | $45 - $130 | 133% |
| Athens Administrators Ahmc Work Comp | $46 | 136% |
| Misc 1 | $46 | 136% |
| Multiplan Wc | $46 | 136% |
| Ahmc Health | $47 | 139% |
| Knox-Keene Act | $47 | 139% |
| Multiplan | $51 - $148 | 151% |
| Capnet | $60 | 178% |
| Cigna | $60 - $174 | 178% |
| Commercial Non Contract | $60 - $174 | 178% |
| Medi-Cal Sub Acute | $60 - $174 | 178% |
| One Legacy | $60 - $174 | 178% |
| Pacific Independent Physician Association | $60 | 178% |
| Edward Medical Group | $65 | 193% |
| Allied Physicians Ipa | $69 | 205% |
| Health Net Inc | $92 - $135 | 273% |
| Davita Healthcare Partners | $94 | 279% |
| Healthnet | $113 - $234 | 335% |
| Great-West Healthcare Of California | $2,500 | 7412% |