CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Saint Francis Hospital-Evanston

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $36
  • Cash Discount Price: $34
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Saint Francis Hospital-Evanston is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $34. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 355 Ridge Ave, Evanston, IL.
Cash / Self-Pay
$34

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $34 (101%)
Insurance Median: $36 (107%)
Cash: $34 (101% of Medicare)
Ins. Median: $36 (107% 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
Blue Cross Blue Shield $33 - $48 98%
Aetna $34 - $45 101%
Celtic (Wellcare) $34 101%
Cigna $34 101%
Clear Spring Health Of Illinois $34 101%
Devoted Health $34 101%
Essential Health Partners $34 - $40 101%
Humana $34 - $45 101%
Illinois Physicians Alliance $34 101%
Longevity Health Plan Of Illinois $34 101%
Medicare (plans) $34 101%
Ravenswood Physicians Associates Ipa $34 101%
Resurrection Physicians Provider Group Ipa $34 101%
Self-Pay $34 101%
Tricare $34 101%
UnitedHealthcare $34 - $43 101%
Molina $35 - $52 104%
Zing Health Provider Network $35 104%
Meridian $36 - $48 107%
Provider Partners Health Plan (Pphp) $36 107%
Access Community Health Network $41 122%
Countycare $45 133%
Medicaid / KanCare $45 133%
Clifton Health Systems $53 157%
Ambetter / Centene $56 166%
Hfn Inc (Healthcare Finest Network) $79 234%
Coventry $81 240%
Workers Comp $81 240%
Imagine Health Network, Inc. $118 350%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 355 Ridge Ave, Evanston, IL 60202
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals