CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Piedmont Augusta Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $173
Cash Discount Price: $80
vs. Medicare Baseline: 5.13x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Piedmont Augusta Hospital is $173. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $80. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 5.13x the Medicare baseline. Located in 1350 Walton Way, Augusta, GA.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$173

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: $80 (237%)

Insurance Median: $173 (513%)

Cash: $80 (237% of Medicare)

Ins. Median: $173 (513% 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 513% of the Medicare baseline (a markup of 413%). 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
Blue Cross Blue Shield	$37 - $273	110%
Absolute Total Care [20109]	$60	178%
Medicaid / KanCare	$61 - $64	181%
Alliant Health Plans Of Georgia [10952]	$96 - $101	285%
Alliant Solocare [11101]	$96 - $101	285%
Medcost [10966]	$103 - $109	305%
Multiplan [10600]	$114 - $120	338%
Phcs [10601]	$114 - $120	338%
Industry Buying Group [10840]	$169 - $177	501%
Kaiser [10500]	$192 - $202	569%
UnitedHealthcare	$215 - $273	637%
First Health [10303]	$220 - $232	652%
Novanet [10819]	$233 - $246	691%
Aetna	$259 - $273	768%
Cigna	$259 - $273	768%

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 $80.
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 Piedmont Augusta 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.