CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Kossuth Regional Health Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $73
  • Cash Discount Price: $69
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Kossuth Regional Health Center is $73. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $69. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.16x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.
Cash / Self-Pay
$69

Average discount available for prompt cash payment at this facility.

Insurance Median
$73

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: $69 (205%)
Insurance Median: $73 (216%)
Cash: $69 (205% of Medicare)
Ins. Median: $73 (216% 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 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Amerigroup Mcr Adv - All Other Plans $33 98%
Humana $33 98%
Mercy One - All Plans $33 98%
Va Ccn - All Plans $33 98%
UnitedHealthcare $34 - $65 101%
Health Partners New Bus - All Other Plans $60 178%
Midlands Choice - All Plans $60 178%
Medical Associates - All Plans $73 216%
Preferred Health - All Plans $73 216%
Aetna $80 - $83 237%
Multiplan - All Plans $82 243%
Health Partners Exisiting Bus $83 246%
Amerigroup Mcaid $89 264%
Molina Mcaid/Chip - All Plans $89 264%
Blue Cross Blue Shield $191 - $210 566%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1515 South Phillips Street, Algona, IA 50511
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals