CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Horn Memorial Hospital

Billing Code: 97750 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$104
about 3.1× the $34 Medicare rate · typically $35–$190
modeled estimate · not a bill or quote
Medicare pays $34 Fair price $104 Cash price $56 Hospital's list price $70

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

3 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna CignaHumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $42 - $69 125%
Blue Cross Blue Shieldmajor $182 540%
Aetnamajor $42 125%
Amerigroup $42 - $44 125%
Molina $42 125%
Government programs also on file: Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 701 E 2Nd St, Ida Grove, IA 51445
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals