Physical therapy (functional capacity test)
Facility: St. Catherine Hospital - Garden City
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $126
- Cash Discount Price: $63
- vs. Medicare Baseline: 3.74x 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 374% of the Medicare baseline (a markup of 274%). 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 |
|---|---|---|
| Denver Health | $24 - $90 | 71% |
| Kaiser | $28 - $105 | 83% |
| Direct To Employer | $28 - $153 | 83% |
| UnitedHealthcare | $33 - $232 | 98% |
| Cigna | $34 - $202 | 101% |
| Humana | $34 | 101% |
| Blue Cross Blue Shield | $34 - $205 | 101% |
| Kansas Health | $34 | 101% |
| Medicare (plans) | $34 | 101% |
| Innovage | $34 | 101% |
| Aetna | $34 - $160 | 101% |
| Devoted Health | $34 | 101% |
| Peak Health | $40 - $149 | 119% |
| Centura Employee Plan | $72 | 213% |
| Multiplan | $87 - $325 | 258% |
| Wpaa | $105 - $115 | 311% |
| Christian Health Aid | $119 - $131 | 353% |
| United Colorado Doctor'S Plan | $143 - $150 | 424% |
| Health Partners Of Kansas | $145 - $159 | 430% |
Consumer Guidance & Cost Commentary
For the physical therapy functional capacity test (CPT 97750) at St. Catherine Hospital in Garden City, KS, the cash price is $63.00, which is significantly lower than the facility's gross charge of $157.00. While the hospital's negotiated rates with major payers like UnitedHealthcare and Multiplan range from $34 to $325, the cash price offers a distinct advantage for patients with high-deductible plans or those seeking immediate payment, as it bypasses the administrative overhead and markup inherent in insurance billing cycles. It is important to note that while Medicare sets a benchmark of $33.73 for this service, commercial negotiated rates often exceed this baseline due to contract dynamics, making the cash option a potentially more cost-effective choice if you have not yet met your deductible or if your insurance allowed amount is higher than the cash price.
Patients should be aware that balance billing can occur if an out-of-network provider bills the difference between the full chargemaster rate and what your insurance pays, though the No Surprises Act protects against this for emergency care and non-emergency services at in-network facilities. To avoid unexpected costs, we strongly recommend requesting a prompt-pay discount or self-pay rate before scheduling, as paying in full upfront can reduce the bill by 20% to 50% by bypassing claims processing fees. If you receive a summary bill, do not accept it as final; instead, request a detailed itemized audit to verify that no unbundled codes or services not rendered have been charged, as over 80% of hospital bills contain errors that can be corrected through a formal written dispute.