CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Bluffton Regional Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $57
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 1.69x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Bluffton Regional Medical Center is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.69x the Medicare baseline. Located in 303 S Main St, Bluffton, IN.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$57

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: $37 (110%)
Insurance Median: $57 (169%)
Cash: $37 (110% of Medicare)
Ins. Median: $57 (169% 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
Amish Aid $20 - $27 59%
Physicians Health Plan $20 - $54 59%
Self Pay $20 - $63 59%
Align Networks $25 - $80 74%
Lutheran Preferred Network $25 - $91 74%
Theramatrix $25 74%
Php Freedom Network $26 - $64 77%
Cigna $27 - $40 80%
Php $27 - $52 80%
UnitedHealthcare $29 - $186 86%
Aetna $30 - $51 89%
Tricare $30 89%
Blue Cross Blue Shield $32 - $186 95%
Department Of Veterans Affairs $32 95%
Humana $32 - $186 95%
Medicare (plans) $32 95%
Node Caresource Mcr Adv $32 95%
Node Devoted Health Mcr Adv $32 95%
Node Iu Health Mcr Adv $32 95%
Node Mhs Mcr Adv $32 95%
Node Non Par Hospice Agree $32 95%
Node Va $32 95%
Northeast Hospice $32 95%
Veterans Eval Services $32 95%
Php Management Systems $33 - $44 98%
County Jail Health Care $34 101%
In Dept Of Correction $34 101%
Lutheran Trma $34 - $51 101%
Node Pphp Mcr Adv $34 101%
Encore Ppo $41 - $56 122%
Sagamore Sebt $43 - $58 127%
Sagamore Health Newtork Inc $45 - $95 133%
Lutheran Advanced Network $48 142%
Lutheran Three Rivers Preferred Plus 150 $48 142%
Us Department Of Labor $50 148%
Consumer Life $52 - $71 154%
Ahg Dana Employees $55 - $74 163%
Lutheran Three Rivers Preferred Plus 175 $56 166%
Encore Work Comp In $58 172%
Prime Health Services $58 - $86 172%
Private Healthcare Systems Inc $63 - $86 187%
Lutheran Northwest Health Preferred $64 190%
Managed Health Services Exchange $64 190%
Workers Compensation $64 190%
Multiplan $67 - $91 199%
Encore Health Network $69 - $103 205%
Advantage 360 $70 - $95 208%
Community Health Alliance $71 - $97 210%
First Health $72 - $98 213%
Allied Benefit Systems $76 - $103 225%
Cardinal Health Alliance $76 - $103 225%
Ppom $76 - $103 225%
Encore Kba Epo $77 228%
Medrisk In Work Comp $84 - $114 249%
Encore Kba Ppo $97 288%
Caresource $186 551%
Medicaid / KanCare $186 551%
Mhs $186 551%
Mhs In Hip $186 551%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 303 S Main St, Bluffton, IN 46714
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals