Physical therapy (functional capacity test)
Facility: Kansas Medical Center Llc
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $32
- Cash Discount Price: $42
- 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 |
|---|---|---|
| Medicaid / KanCare | $18 | 53% |
| Tricare | $28 | 83% |
| Wppa | $28 | 83% |
| Indian Health | $29 | 86% |
| Blue Cross Blue Shield | $32 - $51 | 95% |
| Ambetter / Centene | $32 | 95% |
| Humana | $32 | 95% |
| Medadv_Wellcare | $32 | 95% |
| Three_Rivers | $64 | 190% |
| Aetna | $64 | 190% |
| United | $71 | 210% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test at Kansas Medical Center Llc in Andover, the cash median price is $42.00. This cash rate is notably lower than the negotiated rates paid by most commercial payers, which range from $32.00 to $71.00 depending on the insurer. For patients with high-deductible plans, paying the cash price of $42.00 upfront may be more cost-effective than relying on insurance, as many commercial negotiated rates exceed the cash amount. Additionally, patients should verify if the facility offers self-pay or prompt-pay discounts, which can further reduce the final bill by bypassing administrative claim processing fees.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $33.73 for this service. The cash price of $42.00 is approximately 125% of the Medicare amount, aligning with fair pricing standards that typically fall between 120% and 150% of the federal baseline. While the facility is a Proprietary Acute Care Hospital in Kansas, the specific county or state average data for this code was not provided in the available records. Consumers are advised to request an itemized bill before payment to ensure no unbundled charges or services not rendered are included, and to dispute any errors in writing rather than accepting summary invoices.