Physical therapy (functional capacity test)
Facility: Ascension Via Christi Hospital Manhattan, Inc
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $32
- Cash Discount Price: $33
- vs. Medicare Baseline: 0.95x 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 |
|---|---|---|
| UnitedHealthcare | $18 - $88 | 53% |
| Aetna | $18 | 53% |
| Medicaid / KanCare | $18 - $28 | 53% |
| Medicare (plans) | $31 - $32 | 92% |
| Humana | $31 - $32 | 92% |
| Va | $31 | 92% |
| Providrs Care | $41 | 122% |
| Smarthealth | $44 | 130% |
| Ambetter / Centene | $53 | 157% |
| Blue Cross Blue Shield | $58 - $61 | 172% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, the facility's cash price of $33.00 is notably lower than the negotiated rates charged by most insurance payers, which range from $18 to $88. While the facility's cash rate is slightly below the state of Kansas average, commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. Because insurance negotiated rates can exceed the cash price, patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, provided they verify the facility's self-pay or prompt-pay discounts before scheduling.
The facility's negotiated rates align closely with the Medicare benchmark of $33.73, with most commercial payers falling within a narrow range of $31 to $61, indicating a relatively transparent pricing structure compared to the facility's gross charge of $83.00. This proximity to the Medicare rate suggests the facility is pricing near the "true cost" of service delivery rather than applying a significant markup. To ensure you receive the most accurate pricing, it is recommended to request an itemized bill and confirm whether your specific plan qualifies for the prompt-pay discount, which can reduce the final amount by 20% to 50% if paid upfront.