Physical therapy (functional capacity test)
Facility: Stormont Vail Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $18
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.53x 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.
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 | $18 - $82 | 53% |
| UnitedHealthcare | $18 | 53% |
| Ambetter / Centene | $18 | 53% |
Consumer Guidance & Cost Commentary
For this physical therapy functional capacity test at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $18 to $82 across three major payers, with a median paid amount of $81.90. It is important to note that the cash median price is not available for this service, meaning patients without insurance cannot use a cash discount to lower their cost. While commercial negotiated rates often include administrative overhead that can inflate the price by 20% to 40% compared to the true cost of care, the data provided does not include a specific county or state average for comparison. However, the facility's Medicare benchmark of $33.73 serves as a reliable baseline for evaluating pricing fairness, as commercial rates are frequently marked up significantly above this federal cost standard.
Patients should be aware that balance billing is generally prohibited for in-network services under the No Surprises Act, protecting consumers from unexpected bills based on the hospital's full chargemaster list. If you have a high-deductible plan, you may still face the full negotiated rate until your deductible is met, even if the cash price were lower. To potentially reduce costs, it is advisable to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can offer immediate fee reductions for upfront payment. Additionally, if you receive a bill, always request a detailed itemized audit to identify any errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies that can be corrected through formal written disputes.