CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Franciscan Health Crown Point

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $83
Cash Discount Price: $25
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Franciscan Health Crown Point is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $25. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.46x the Medicare baseline. Located in 1201 S Main St, Crown Point, IN.

Cash / Self-Pay

$25

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $25 (74%)

Insurance Median: $83 (246%)

Cash: $25 (74% of Medicare)

Ins. Median: $83 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Research/Grant [2012]	$5	15%
Blue Cross Blue Shield	$28 - $97	83%
Commercial [2001]	$32 - $185	95%
Managed Care [2000]	$32 - $203	95%
Medicare (plans)	$32	95%
Aetna	$35 - $90	104%
Cigna	$37 - $95	110%
Great West Insurance [1055]	$37 - $95	110%
Unicare [1150]	$63 - $64	187%
Workers Comp [1172]	$65	193%
United Medical Resources [1158]	$185 - $203	548%
United Medical Resources [1301]	$185 - $203	548%
UnitedHealthcare	$185 - $203	548%
Managed Health Services [1302]	$186 - $192	551%
Mdwise [1175]	$186	551%
Medicaid / KanCare	$186 - $224	551%

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 $25.
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 Franciscan Health Crown Point 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.