CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Adventist Health Mendocino Coast

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $112
Cash Discount Price: $106
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Adventist Health Mendocino Coast is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $106. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.32x the Medicare baseline. Located in 700 River Drive, Fort Bragg, CA.

Cash / Self-Pay

$106

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $106 (314%)

Insurance Median: $112 (332%)

Cash: $106 (314% of Medicare)

Ins. Median: $112 (332% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 332% of the Medicare baseline (a markup of 232%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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%
Partnership Hp Mcal-All Plans	$49	145%
Blue Shield Epn	$60	178%
Tricare	$78	231%
Ah Employee Health Plan - All Plans	$83	246%
UnitedHealthcare	$86 - $130	255%
Great West Hmo/Pos/Epo/Oa	$104	308%
Healthnet - All Plans	$104	308%
Great West Ppo - All Other Plans	$112	332%
Multiplan - All Plans	$112	332%
Blue Shield - All Other Plans	$123	365%
Cigna	$125	371%
Ahcc - All Plans	$144	427%
Beech Street - All Plans	$144	427%
Blue Cross Blue Shield	$308 - $347	913%

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 $106.
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 Mendocino Coast 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.