CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Kosciusko Community Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $60
  • Cash Discount Price: $33
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Kosciusko Community Hospital is $60. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $33. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.78x the Medicare baseline. Located in 2101 E Dubois Dr, Warsaw, IN.
Cash / Self-Pay
$33

Average discount available for prompt cash payment at this facility.

Insurance Median
$60

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: $33 (98%)
Insurance Median: $60 (178%)
Cash: $33 (98% of Medicare)
Ins. Median: $60 (178% 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 $18 - $34 53%
Self Pay $18 - $63 53%
Theramatrix $25 74%
Lutheran Preferred Network $27 - $130 80%
UnitedHealthcare $29 - $186 86%
Align In Work Comp $30 89%
One Call Work Comp $30 89%
Tricare $30 89%
Physicians Health Plan $31 - $75 92%
Aetna $32 - $86 95%
Blue Cross Blue Shield $32 - $186 95%
Department Of Veterans Affairs $32 95%
Humana $32 - $186 95%
Iu Health $32 95%
Medicare (plans) $32 95%
Mhs $32 - $186 95%
Node Devoted Health Mcr Adv $32 95%
Node Non Par Hospice Agree $32 95%
Node Va $32 95%
One Call Care Diagnostics Wc $32 95%
Php Freedom Network $32 - $63 95%
Veterans Eval Services $32 95%
Encore $34 - $65 101%
In Dept Of Correction $34 101%
Node Pphp Mcr Adv $34 101%
Trma Inc $34 - $73 101%
Lutheran Advanced Network $48 142%
Lutheran Preferred $48 - $64 142%
Connecticut General Life Insurance Company $49 - $95 145%
Us Department Of Labor $50 148%
Cigna $53 - $102 157%
Encore Work Comp In $58 172%
Prime Health Services $58 - $122 172%
First Health Network $63 - $122 187%
Managed Health Services Exchange $64 190%
Workers Comp $64 190%
Advantage Health $70 - $134 208%
Private Healthcare Systems $72 - $139 213%
Sagamore $74 - $152 219%
Encore Kba Epo $77 228%
Encore Health Network $78 - $151 231%
Encore Kba Ppo $97 288%
Caresource $143 - $186 424%
Managed Health Services $186 551%
Medicaid / KanCare $186 551%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2101 E Dubois Dr, Warsaw, IN 46580
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals