Physical therapy (functional capacity test)
Facility: Wichita County Health Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $69
- Cash Discount Price: $61
- vs. Medicare Baseline: 2.05x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $57 - $68 | 169% |
| UnitedHealthcare | $69 - $83 | 205% |
Consumer Guidance & Cost Commentary
For this Physical therapy (functional capacity test) at Wichita County Health Center, the cash median price is $61.00, which is lower than the facility's negotiated rates of $69.00 and the median paid by insurers at $63.00. While the facility is a Critical Access Hospital in Leoti, KS, with government-local ownership, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront incentives can significantly reduce the final cost.
The Medicare benchmark for this service is $33.73, which serves as a baseline for evaluating the facility's pricing markup. Although the data does not provide specific state or county average comparisons for this code, the facility's cash rate of $61.00 represents a standard commercial pricing point. If you receive an itemized bill that includes unexpected charges or broad category summaries, you should request a full line-by-line audit to identify errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Always dispute any balance billing or errors in writing to ensure you are only paying for the actual services provided at the agreed-upon rates.