CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: University of Iowa Health Care Medical Center Down

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $129
Cash Discount Price: $155
vs. Medicare Baseline: 3.82x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at University of Iowa Health Care Medical Center Down is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $155. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.82x the Medicare baseline. Located in 500 E Market Street, Iowa City, IA.

Cash / Self-Pay

$155

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $155 (460%)

Insurance Median: $129 (382%)

Cash: $155 (460% of Medicare)

Ins. Median: $129 (382% 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 382% of the Medicare baseline (a markup of 282%). 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
Wellpoint (Amerigroup)	$24 - $33	71%
Iowa Total Care	$25 - $33	74%
Molina Healthcare	$25 - $32	74%
Aetna	$27 - $134	80%
Blue Cross Blue Shield	$32 - $107	95%
Healthpartners	$32 - $190	95%
Medical Associates	$32 - $149	95%
UnitedHealthcare	$32 - $169	95%
Immergrun	$37 - $56	110%
Quad City Community Healthcare	$50 - $167	148%
Aplos Health Plan	$80 - $178	237%
Midlands Choice	$82 - $145	243%
Oscar Health	$93 - $140	276%
Great River Health Systems	$103 - $156	305%
Sedgwick	$118 - $178	350%
Global Excel	$125 - $190	371%
Sanford Health Plan	$125 - $190	371%
Employee Benefit Systems	$129 - $201	382%
Sisco	$129 - $196	382%
Healthsmart	$132 - $201	391%
Hfn	$135 - $205	400%
Multiplan	$135 - $205	400%

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 $155.
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 University of Iowa Health Care Medical Center Down 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.