Physical therapy (functional capacity test)
Facility: Menorah Medical Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $50
- Cash Discount Price: $361
- 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 |
|---|---|---|
| Medicaid / KanCare | $18 | 53% |
| Aetna | $18 - $184 | 53% |
| Unicare | $18 | 53% |
| Healthyblue | $18 | 53% |
| United | $18 - $162 | 53% |
| Amerigroup | $18 | 53% |
| Devoted Health | $28 - $32 | 83% |
| Humana | $28 - $71 | 83% |
| Coventry | $28 - $145 | 83% |
| Blue Cross Blue Shield | $28 - $162 | 83% |
| Wellcare | $29 - $32 | 86% |
| Celtic | $29 - $32 | 86% |
| Cigna | $29 - $289 | 86% |
| Pyramid Life | $30 - $34 | 89% |
| Triwest Health Alliance | $31 | 92% |
| Home State Health Plan | $31 | 92% |
| Multiplan | $41 - $267 | 122% |
| Corvel Corporation | $48 - $235 | 142% |
| Oha Network | $50 - $180 | 148% |
| Ambetter / Centene | $67 | 199% |
| Oscar | $69 | 205% |
| Nhc Advantage | $69 | 205% |
| Wppa Providrs Care Network | $72 | 213% |
| Universal Healthcare | $126 | 374% |
| Coventry Kc Mo | $148 | 439% |
| College Park Family Care Center | $155 | 460% |
| Cco, Inc. | $271 | 803% |
| Focus Healthcare Mgmt, Inc | $271 | 803% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Menorah Medical Center in Overland Park, KS, the cash price is $361.00, which matches the facility's cash median. This rate is significantly higher than the state average, represented by a 1.5x markup compared to the Medicare amount of $33.73. While commercial insurance plans like Aetna and United offer negotiated rates ranging from $18 to $184, these figures often exceed the cash price for patients with high-deductible plans. In such cases, paying the cash rate of $361.00 upfront can be more cost-effective than relying on insurance reimbursement, especially if the negotiated rate exceeds the cash amount. Patients should verify their specific plan's allowed amount before scheduling to determine if the cash option provides the best financial outcome.
To maximize savings, patients should proactively ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% for upfront payment. These discounts bypass the administrative costs associated with insurance claims processing and provide immediate liquidity to the facility. Additionally, since the facility is an in-network provider for many payers, the No Surprises Act generally protects patients from balance billing for out-of-network services at this location. However, patients should always request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors that can be corrected through a formal written audit dispute.