CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Mc Donough District Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $64
  • Cash Discount Price: $48
  • vs. Medicare Baseline: 1.90x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mc Donough District Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $48. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.90x the Medicare baseline. Located in 525 East Grant Street, Macomb, IL.
Cash / Self-Pay
$48

Average discount available for prompt cash payment at this facility.

Insurance Median
$64

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: $48 (142%)
Insurance Median: $64 (190%)
Cash: $48 (142% of Medicare)
Ins. Median: $64 (190% 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
Aetna $15 - $98 44%
Health Alliance $19 - $87 56%
Hfn $29 - $88 86%
UnitedHealthcare $29 - $88 86%
Humana $32 - $88 95%
Medicaid / KanCare $32 - $98 95%
Medicare (plans) $32 95%
Meridian $32 95%
Molina $32 - $98 95%
Mutual Medical $32 - $98 95%
Tricare $32 95%
Veteran Affairs $32 95%
Blue Cross Blue Shield $45 - $98 133%
Springfield Health $52 - $80 154%
Consociate $54 - $83 160%
Trilogy $54 - $83 160%
Blue Choice $57 - $88 169%
Current Health $57 - $88 169%
Healthlink $57 - $92 169%
Preferred Plan $60 - $93 178%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 525 East Grant Street, Macomb, IL 61455
  • CMS Rating: ★★★☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals