CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Davis County Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $44
  • Cash Discount Price: $74
  • vs. Medicare Baseline: 1.30x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Davis County Hospital is $44. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $74. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.30x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$74

Average discount available for prompt cash payment at this facility.

Insurance Median
$44

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: $74 (219%)
Insurance Median: $44 (130%)
Cash: $74 (219% of Medicare)
Ins. Median: $44 (130% 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.

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 $37 110%
Choicecare Mcr Adv $40 119%
Home State Hlth Exch - All Other Plans $40 119%
Home State Hlth Mcr $40 119%
Mt Carmel Hp-All Plans $40 119%
Tricare $40 119%
Amerigroup Mcr Adv-All Other Plans $41 122%
American Hp Mcr Adv-All Plans $42 125%
Home State Hlth Mcaid $44 130%
Iowa Total Care Mcaid-All Plans $45 133%
Amerigroup Mcaid $46 136%
Molina Mcaid-All Plans $46 136%
Midlands Choice - All Plans $52 154%
Preferred Hlth Choices - All Plans $56 166%
Choicecare Comm - All Other Plans $70 208%
Blue Cross Blue Shield $182 - $200 540%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals