CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Memorial Hospital and Manor

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $88
Cash Discount Price: $80
vs. Medicare Baseline: 2.61x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Memorial Hospital and Manor is $88. 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 2.61x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.

Cash / Self-Pay

$80

Average discount available for prompt cash payment at this facility.

Insurance Median

$88

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: $88 (261%)

Cash: $80 (237% of Medicare)

Ins. Median: $88 (261% 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 261% of the Medicare baseline (a markup of 161%). 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
Tricare	$30	89%
Aetna	$32 - $103	95%
Humana	$32 - $91	95%
Medicare (plans)	$32	95%
Wellcare_Plan	$32	95%
Ambetter / Centene	$41	122%
Alliant_Plan	$51	151%
Amerigroup_Plan	$72	213%
Medicaid / KanCare	$72	213%
Peach_State_Health_Plan_Plan	$72	213%
Caresource_Plan	$75	222%
Blue Cross Blue Shield	$88	261%
Uhc_Plan	$90	267%
Novanet_Plan	$91	270%
Cigna	$95	282%
Private_Healthcare_Systems_Plan	$97	288%
Multiplan_Plan	$103	305%
Corvel_Plan	$108	320%
Tnga_Plan	$450	1334%

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 Memorial Hospital and Manor 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.