CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Mercyone Centerville Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $223
Cash Discount Price: $238
vs. Medicare Baseline: 6.61x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mercyone Centerville Medical Center is $223. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 6.61x the Medicare baseline. Located in One St Joseph's Drive, Centerville, IA.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$223

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: $238 (706%)

Insurance Median: $223 (661%)

Cash: $238 (706% of Medicare)

Ins. Median: $223 (661% 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 661% of the Medicare baseline (a markup of 561%). 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
Medicare (plans)	$65 - $72	193%
Iowa Total Care	$66	196%
Medicaid / KanCare	$67	199%
Blue Cross Blue Shield	$68	202%
Aetna	$69 - $223	205%
UnitedHealthcare	$73 - $238	216%
Amish Hospital Aid	$92	273%
Ambetter / Centene	$116	344%
Claimdoc	$139	412%
Nova	$139	412%
Health Choices	$182	540%
Medical Associates	$182	540%
Geha	$208	617%
1199 National Benefit Fund	$223	661%
Allied Benefit Systems	$223	661%
Asr Health Benefits	$223	661%
Christian Brother Services	$223	661%
Coventry	$223	661%
First Health	$223	661%
Lucent Health	$223	661%
Luminare Health	$223	661%
Medical Mutual	$223	661%
Meritain	$223	661%
Trustmark Small Business Benefits	$223	661%
Webtpa	$223	661%
Health Partners	$229	679%
Auxiant	$233	691%
Cigna	$233	691%
Medica	$233	691%
Midlands	$233	691%
Midlands Choice	$233	691%
Crime Victim Assistance	$238	706%
Iowa Dept Of Public Health	$238	706%

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 $238.
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 Mercyone Centerville Medical Center 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.