CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: HCA Florida Highlands Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $35
  • Cash Discount Price: $415
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at HCA Florida Highlands Hospital is $35. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $415. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.04x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
$415

Average discount available for prompt cash payment at this facility.

Insurance Median
$35

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: $415 (1230%)
Insurance Median: $35 (104%)
Cash: $415 (1230% of Medicare)
Ins. Median: $35 (104% 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.

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
Devoted Health $29 - $33 86%
Humana $29 - $166 86%
Ndms Definitive Care $29 - $33 86%
United $29 - $187 86%
Wellmed $29 - $33 86%
Aetna $30 - $124 89%
Blue Cross Blue Shield $30 - $34 89%
American Health Plan $31 - $35 92%
Cigna $31 - $146 92%
Florida Complete Care $31 - $35 92%
Prominence Healthfirst $31 - $35 92%
Sunshine State $31 - $36 92%
Centurion $32 - $36 95%
Amerihealth Caritas $35 - $40 104%
Longevity Health Plan $35 - $40 104%
Freedom Health $36 107%
Avmed $54 - $208 160%
Molina $79 234%
Oscar $79 234%
Simply Healthcare $98 291%
Office Of Sheiff Highland Co $145 430%
United Ppo $183 543%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals