CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Atrium Health Navicent Peach

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $52
Cash Discount Price: $77
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Atrium Health Navicent Peach is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $77. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.54x the Medicare baseline. Located in 1960 Highway 247 Connector, Byron, GA.

Cash / Self-Pay

$77

Average discount available for prompt cash payment at this facility.

Insurance Median

$52

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: $77 (228%)

Insurance Median: $52 (154%)

Cash: $77 (228% of Medicare)

Ins. Median: $52 (154% 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.

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
Aetna	$32 - $91	95%
Blue Cross Blue Shield	$32 - $120	95%
Georgia Health Advantage	$32 - $36	95%
Humana	$32 - $131	95%
Pruitt Health	$32 - $38	95%
UnitedHealthcare	$32 - $97	95%
Care Source	$33 - $37	98%
Clover	$33 - $37	98%
Eon Health	$33 - $37	98%
Alliant	$37 - $75	110%
Ambetter / Centene	$41 - $79	122%
Cigna	$43 - $112	127%
Securehealth	$52 - $100	154%
Multiplan	$100 - $123	296%
Novanet	$123	365%
Three Rivers Provider Network	$131	388%
Beechstreet	$143	424%

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 $77.
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 Atrium Health Navicent Peach 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.