CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Marion Communtiy Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $53
  • Cash Discount Price: $363
  • vs. Medicare Baseline: 1.57x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Marion Communtiy Hospital is $53. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $363. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.57x the Medicare baseline. Located in 1431 Sw 1St Ave, Ocala, FL.
Cash / Self-Pay
$363

Average discount available for prompt cash payment at this facility.

Insurance Median
$53

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: $363 (1076%)
Insurance Median: $53 (157%)
Cash: $363 (1076% of Medicare)
Ins. Median: $53 (157% 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
Avmed $25 - $103 74%
Simply Healthcare $27 - $47 80%
Devoted Health $29 - $33 86%
Humana $29 - $74 86%
Ndms Definitive Care $29 - $33 86%
United $29 - $166 86%
Va Purchased Care Program $29 - $33 86%
Veterans Evaluation Services $29 - $33 86%
Wellmed $29 - $33 86%
Blue Cross Blue Shield $30 - $34 89%
Freedom Optimum $30 - $34 89%
Aetna $31 - $111 92%
Align Senior Care $31 - $35 92%
American Health Plan $31 - $35 92%
Cigna $31 - $154 92%
Florida Complete Care $31 - $35 92%
Secur $31 - $36 92%
Sunshine State $31 - $35 92%
Wellcare $31 - $35 92%
Centurion $32 - $36 95%
Clear Spring Health $32 - $36 95%
Gold Kidney Of Florida $32 - $36 95%
Careplus $33 - $38 98%
Ultimate Health Plan $33 - $38 98%
Longevity Health Plan $35 - $40 104%
Molina Healthcare $40 - $118 119%
Evolutions $49 - $85 145%
Evolutions Healthcare $49 - $85 145%
Sunshine State Health Plan $54 - $94 160%
Naphcare $61 - $79 181%
University Ma Federal Corrections $61 - $69 181%
Wellpath $61 - $79 181%
Plotkin Health $106 - $185 314%
Prime Health Sheriff $106 - $185 314%
Multiplan $165 - $288 489%
Ppo Next $180 - $314 534%
Novanet $191 - $333 566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1431 Sw 1St Ave, Ocala, FL 34471
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals