CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Hammond Henry Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $74
Cash Discount Price: $81
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Hammond Henry Hospital is $74. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $81. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.19x the Medicare baseline. Located in 600 N College Avenue, Geneseo, IL.

Cash / Self-Pay

$81

Average discount available for prompt cash payment at this facility.

Insurance Median

$74

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: $81 (240%)

Insurance Median: $74 (219%)

Cash: $81 (240% of Medicare)

Ins. Median: $74 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Tricare	$23	68%
Aetna	$26 - $86	77%
Health Alliance Mcare Adv	$26	77%
UnitedHealthcare	$26 - $133	77%
Wellmark Of Ia-All Plans	$45	133%
Blue Cross Blue Shield	$50 - $86	148%
Springfield Armory-All Plans	$58	172%
Ambetter / Centene	$63	187%
Health Alliance-All Other Plans	$68	202%
Multiplan Integrated Hp	$68	202%
Cigna	$69	205%
Multiplan Pponext	$72	213%
Osf Direct Access Network-All Plans	$72	213%
Multiplan-All Other Plans	$76	225%
Corvel-All Plans	$81	240%
Healthsmart Adult-All Other Plans	$81	240%
Healthsmart Pediatric	$81	240%
Hfn-All Plans	$81	240%
Multiplan Beech Street	$81	240%
Multiplan Phcs Adult	$81	240%
Multiplan Phcs Pediatric	$81	240%
Usa Mco-All Plans	$81	240%
Meridian Health Plan-All Plans	$86	255%
Quad City Community Hc-All Plans	$90	267%
Humana	$120	356%

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 $81.
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 Hammond Henry Hospital 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.