CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Eastern Idaho Regional Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $65
Cash Discount Price: $164
vs. Medicare Baseline: 1.93x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Eastern Idaho Regional Medical Center is $65. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.93x the Medicare baseline. Located in 3100 Channing Way, Idaho Falls, ID.

Cash / Self-Pay

$164

Average discount available for prompt cash payment at this facility.

Insurance Median

$65

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: $164 (486%)

Insurance Median: $65 (193%)

Cash: $164 (486% of Medicare)

Ins. Median: $65 (193% 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.

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
Blue Cross Blue Shield	$27 - $156	80%
Molina	$27 - $32	80%
Prime Health	$28 - $140	83%
Regence Blue Shield	$28 - $32	83%
Rexburg Care And Rehab	$28 - $32	83%
Triwest Healthcare Alliance	$28 - $32	83%
Veteran'S Administration	$28 - $32	83%
Humana	$29 - $138	86%
United	$29 - $95	86%
Select Health	$50	148%
Select Health Ichn Brightpath	$50 - $56	148%
Regence	$51	151%
Select Health Idaho (Eirmc Only)	$52	154%
Aetna	$65 - $80	193%
Doug Andrus Distributing	$66	196%
Pacificsource Health	$69 - $88	205%
University Of Utah	$69	205%
Mountain Health Co-Op	$82 - $123	243%
Cigna	$90	267%
First Choice Health Of Washington	$99	294%
Moda	$102	302%
Dmba	$106	314%
Geha Ppo Usa	$131	388%
Multiplan	$138 - $148	409%
First Choice Of The Midwest	$148	439%
Interwest Health	$148	439%
St. John'S Health Network	$148	439%
Coventry First Health	$150	445%
Shashone-Bannock Tribal Health	$164	486%

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 $164.
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 Eastern Idaho Regional 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.