CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Nemours Childrens Hospital, Florida

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $351
  • Cash Discount Price: $779
  • vs. Medicare Baseline: 10.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Nemours Childrens Hospital, Florida is $351. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $779. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 10.41x the Medicare baseline. Located in 6535 Nemours Pkwy, Orlando, FL.
Cash / Self-Pay
$779

Average discount available for prompt cash payment at this facility.

Insurance Median
$351

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: $779 (2310%)
Insurance Median: $351 (1041%)
Cash: $779 (2310% of Medicare)
Ins. Median: $351 (1041% 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 1041% of the Medicare baseline (a markup of 941%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $32 95%
Avmed $241 714%
UnitedHealthcare $246 729%
Cigna $248 735%
Employers Health Network Fl $312 925%
Florida Blue $312 - $475 925%
Truli $312 925%
Aetna $343 1017%
Evolutions Healthcare $351 1041%
Integra Administrative Group $467 1385%
Global Medical Management $506 1500%
Prime Health Services $506 1500%
Star Healthcare Network $506 1500%
Velocity $584 1731%
First Health Network $608 1803%
Pnoa $623 1847%
Seminole Tribe Of Fl $623 1847%
Private Healthcare Systems $717 2126%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 6535 Nemours Pkwy, Orlando, FL 32827
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens