Physical therapy (functional capacity test)
Facility: Providence Medical Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $33
- Cash Discount Price: $31
- vs. Medicare Baseline: 0.98x 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 |
|---|---|---|
| Medicaid / KanCare | $18 | 53% |
| Healthy Blue | $18 - $33 | 53% |
| UnitedHealthcare | $18 - $137 | 53% |
| Celtic | $18 - $51 | 53% |
| Aetna | $20 - $32 | 59% |
| Blue Cross Blue Shield | $32 - $75 | 95% |
| Medicare (plans) | $32 | 95% |
| Cigna | $32 | 95% |
| Tricare | $32 | 95% |
| Midland Care Connection | $32 | 95% |
| Kansas Superior Select | $33 | 98% |
| Corizon | $41 | 122% |
| Employer Direct Healthcare | $45 | 133% |
| Well Path Prison | $45 | 133% |
| Centurion | $48 | 142% |
| Naphcare | $49 | 145% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) procedure at Providence Medical Center in Kansas City, KS, the cash payment median is $31.00, which is notably lower than the state average of $33.73. While the facility's negotiated rates with major payers like UnitedHealthcare and Healthy Blue range from $18 to $137, 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 discounts. It is important to note that commercial negotiated rates frequently include administrative overhead and contract markups, sometimes reaching 200% to 300% of the Medicare benchmark of $33.73, whereas fair pricing is typically defined as 120% to 150% of this federal baseline.
To ensure you are not overcharged, we recommend requesting an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. If you choose to use insurance, be aware that while in-network contracts prevent balance billing for emergency care under the No Surprises Act, patients should verify their deductible status and avoid verbal dispute settlements by sending formal written audits to the billing supervisor. Additionally, asking for a prompt-pay discount upfront can reduce the bill by 20% to 50%, bypassing costly claims processing fees and administrative delays that inflate the final cost for commercial payers.