Physical therapy (functional capacity test)
Facility: Overland Park Reg Med Ctr
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $50
- Cash Discount Price: $432
- vs. Medicare Baseline: 1.48x 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% |
| Unicare | $18 | 53% |
| Medicaid / KanCare | $18 | 53% |
| Healthyblue | $18 | 53% |
| Aetna | $18 - $221 | 53% |
| United | $18 - $195 | 53% |
| Devoted Health | $28 - $32 | 83% |
| Humana | $28 - $71 | 83% |
| Blue Cross Blue Shield | $28 - $186 | 83% |
| Coventry | $28 - $174 | 83% |
| Celtic | $29 - $32 | 86% |
| Wellcare | $29 - $32 | 86% |
| Cigna | $29 - $32 | 86% |
| Pyramid Life | $30 - $34 | 89% |
| Home State Health Plan | $31 | 92% |
| Triwest Health Alliance | $31 | 92% |
| Multiplan | $41 - $320 | 122% |
| Corvel Corporation | $48 - $281 | 142% |
| Oha Network | $50 - $216 | 148% |
| Ambetter / Centene | $80 | 237% |
| Nhc Advantage | $82 | 243% |
| Oscar | $82 | 243% |
| Wppa Providrs Care Network | $86 | 255% |
| Universal Healthcare | $151 | 448% |
| Coventry Kc Mo | $177 | 525% |
| College Park Family Care Center | $186 | 551% |
| Cco, Inc. | $324 | 961% |
| Focus Healthcare Mgmt, Inc | $324 | 961% |
Consumer Guidance & Cost Commentary
For this physical therapy functional capacity test at Overland Park Reg Med Ctr, the cash price is $432.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $33.73, reflecting a markup of 1.5 times the federal baseline. While the facility offers a negotiated rate of $50.00 for in-network patients, this amount is still well above the Medicare amount and suggests that commercial contracts may include substantial administrative overhead. Patients with high-deductible plans should consider that paying the full cash price of $432.00 upfront might be more cost-effective than relying on insurance, especially if the negotiated rate exceeds the cash price or if the patient has not yet met their deductible.
The facility has established contracts with 28 different payers, including major networks like Aetna, United, and Humana, though specific negotiated amounts vary widely across these plans. For instance, while some payers have a low-end rate of $18, others like Multiplan and Corvel Corporation have rates starting at $41 and $48 respectively. Because the facility is an in-network Acute Care Hospital, the No Surprises Act protects patients from unexpected balance billing for emergency services or non-emergency care from out-of-network providers at this location. However, patients should still request a detailed itemized bill to verify that all charges align with the CPT code and that no unbundled services or cancelled items have been included. Additionally, patients should ask the billing department about prompt-pay discounts, which could reduce the final cost if the bill is settled in full within a short window.