Physical therapy (functional capacity test)
Facility: Wesley Medical Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $38
- Cash Discount Price: $186
- vs. Medicare Baseline: 1.13x 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 |
|---|---|---|
| Amerigroup | $18 | 53% |
| Medicaid / KanCare | $18 | 53% |
| UnitedHealthcare | $18 | 53% |
| United | $18 - $113 | 53% |
| Aetna | $18 - $90 | 53% |
| Health Partners Of Kansas | $21 - $126 | 62% |
| Wppa | $21 - $44 | 62% |
| Ambetter / Centene | $22 - $45 | 65% |
| Medical Associates Health Plan | $23 - $47 | 68% |
| Preferred Health Choices | $23 - $47 | 68% |
| Coventry Health Care | $28 - $32 | 83% |
| Devoted Health | $28 - $32 | 83% |
| Humana | $28 - $32 | 83% |
| Triwest Health Alliance | $31 | 92% |
| Correct Care Solutions | $42 - $48 | 125% |
| Blue Cross Blue Shield | $44 | 130% |
| First Health | $48 - $116 | 142% |
| Multiplan | $50 - $226 | 148% |
| Triwest Healthcare Alliance | $79 - $163 | 234% |
| Spirit Aerosystems | $80 | 237% |
| Usa Managed Care | $103 - $213 | 305% |
Consumer Guidance & Cost Commentary
For CPT code 97750, Physical therapy (functional capacity test), at Wesley Medical Center in Wichita, KS, the cash price is $186.00. This cash rate is significantly higher than the state average, which is $33.73, and also exceeds the facility's own negotiated rate of $38.00. While commercial payers like Multiplan and Usa Managed Care have negotiated rates reaching up to $213, patients with high-deductible plans may find the cash price more affordable if their insurance allowed amount exceeds $186.00. It is important to note that cash payments can sometimes be cheaper than insurance reimbursement, particularly when the insurer's negotiated rate is higher than the cash-pay option.
Patients should verify their specific plan details before scheduling, as some insurers may have different negotiated rates than the facility's general averages. If you are self-paying, ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final cost. Additionally, be aware of balance billing risks if you receive care from out-of-network providers; under the No Surprises Act, you are protected from balance billing for emergency services and non-emergency services at in-network facilities. If you receive a surprise bill, do not pay immediately; instead, request an itemized audit to identify errors such as unbundled codes or services not rendered, and dispute the charges in writing to protect your financial interests.