CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Longs Peak Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $126
Cash Discount Price: $81
vs. Medicare Baseline: 3.74x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Longs Peak Hospital is $126. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.74x the Medicare baseline. Located in 1750 E Ken Pratt Blvd, Longmont, CO.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$126

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: $81 (240%)

Insurance Median: $126 (374%)

Cash: $81 (240% of Medicare)

Ins. Median: $126 (374% 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 374% of the Medicare baseline (a markup of 274%). 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
Aetna	$34 - $59	101%
Blue Cross Blue Shield	$34 - $388	101%
Cigna	$34 - $163	101%
Cms	$34	101%
Devoted Health	$34	101%
Humana	$34	101%
Kaiser	$34	101%
Select Health	$34 - $85	101%
UnitedHealthcare	$34 - $365	101%
Simplified Benefits Administration	$81 - $96	240%
Denver Health Medical Plan	$115 - $138	341%
Rocky Mountain Health Plan	$117	347%
First Health	$136	403%
Multiplan	$138 - $159	409%
Phcs	$161	477%

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 $81.
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 Longs Peak Hospital 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.