Physical therapy (functional capacity test)
Facility: Salina Regional Health Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $97
- Cash Discount Price: $76
- vs. Medicare Baseline: 2.88x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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 288% of the Medicare baseline (a markup of 188%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $56 - $59 | 166% |
| Preferred Phsic | $58 - $122 | 172% |
| Preferred Healthcare - All Other Plans | $78 - $165 | 231% |
| Multiplan (Mpi)-All Plans | $87 - $184 | 258% |
| Aetna | $87 - $184 | 258% |
| Cigna | $87 - $184 | 258% |
| Providers Care (Wppa)-All Plans | $87 - $184 | 258% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Salina Regional Health Center in Salina, KS, the facility's cash median rate of $76.00 is lower than the state average of $97.00. While the facility's negotiated rates with major payers like Blue Cross Blue Shield and Preferred Phsic range from $56 to $122, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket if they qualify for self-pay or prompt-pay discounts. It is important to note that commercial insurance rates frequently include administrative overhead, which can inflate the baseline price by 20% to 40% compared to direct cash payments.
To ensure you are not overcharged, we recommend requesting an itemized billing audit to verify that all charges align with the specific CPT code and that no unbundled services or cancelled items are included, as over 80% of hospital bills contain errors. Additionally, comparing the facility's pricing to the Medicare benchmark of $33.73 reveals that the cash rate represents a significant markup, which is typical for commercial pricing structures. If you receive a balance bill for out-of-network services, remember that the No Surprises Act protects you from paying the difference between the provider's full chargemaster rate and your insurance allowed amount for emergency care and non-emergency services at in-network facilities.