Physical therapy (functional capacity test)
Facility: Mercy Hospital Columbus
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $113
- Cash Discount Price: $101
- vs. Medicare Baseline: 3.35x 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 335% of the Medicare baseline (a markup of 235%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $29 - $113 | 86% |
| UnitedHealthcare | $29 - $129 | 86% |
| Medicaid / KanCare | $29 - $113 | 86% |
| Medicare (plans) | $32 - $117 | 95% |
| Insurance System Inc Contracted [320465] | $67 | 199% |
| Health Systems Inc Contracted [320174] | $67 | 199% |
| Administrative Payor Contracted [320005] | $70 | 208% |
| Cross Timbers Hospice [20098] | $113 | 335% |
| Globalhealth Contracted [320145] | $113 | 335% |
| Ambetter / Centene | $113 | 335% |
| Cigna | $113 | 335% |
| Home State Health Plan Contracted [320187] | $113 | 335% |
| Novasys Contracted [320285] | $113 | 335% |
| Mercy Hospice Okc [20252] | $113 | 335% |
| Cherokee Nation Health Serv Contracted [320066] | $113 | 335% |
| Humana | $113 - $147 | 335% |
| Kindful Hospice [20434] | $113 | 335% |
| Elara Caring Aspire Hospice [20433] | $113 | 335% |
| Provider Partners Health Plans Contracted [320450] | $113 | 335% |
| Dept Of Veteran Affairs Contracted [320106] | $113 | 335% |
| Kindful Hospice Contracted [320434] | $113 | 335% |
| Aetna | $113 - $140 | 335% |
| Qual Choice Contracted [320325] | $113 | 335% |
| Centurion Of Missouri [20459] | $113 | 335% |
| Medical Associates Health Contracted [320444] | $113 | 335% |
| Tricare | $113 | 335% |
| Indian Health Service Contracted [320198] | $113 | 335% |
| Pace Of The Ozarks Contracted [320518] | $113 | 335% |
| Mercy Mgd Behavioral Health Contracted [320259] | $113 | 335% |
| Halo Hcr Inc Hospice [20432] | $113 | 335% |
| Halo Hcr Inc Hospice Contracted [320432] | $113 | 335% |
| Healthscope Contracted [320182] | $120 | 356% |
| Workers Comp [20426] | $124 - $132 | 368% |
| United Medical Resources Contracted [320454] | $129 - $147 | 382% |
| Medica Contracted [320239] | $139 | 412% |
| American Healthcare Alliance Contracted [320020] | $140 | 415% |
| Healthlink Contracted [320179] | $140 - $147 | 415% |
| First Health Contracted [320128] | $140 | 415% |
| Preferred Health Plan Contracted [320522] | $140 | 415% |
| Usa Managed Care Org Contracted [320429] | $140 | 415% |
| Federal Medical Center Contracted [320127] | $140 | 415% |
| Mercy Benefit Admin Contracted [320251] | $140 - $147 | 415% |
| Aither Health Contracted [320449] | $147 | 436% |
| Ppo Plus Contracted [320310] | $147 | 436% |
| Ebms Contracted [320493] | $147 | 436% |
| Private Health Care Systems Contracted [320320] | $147 | 436% |
| Show-Me Health Administrators Contracted [320483] | $147 | 436% |
| Benefit Management Contracted [320052] | $147 | 436% |
| Point C Contracted [320238] | $147 | 436% |
| Reflect Health Contracted [320492] | $147 | 436% |
| Imagine 360 Contracted [320494] | $147 | 436% |
| Auxiant Contracted [320462] | $147 | 436% |
| 90 Degree Benefits Contracted [320436] | $147 | 436% |
| Yuzu Health Contracted [320521] | $147 | 436% |
| Edison Health Solutions Contracted [320502] | $147 | 436% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Mercy Hospital Columbus, the facility's cash price of $101.00 is notably lower than the median negotiated rate of $113.00 paid by insurance plans. While the facility's cash rate is also below the gross charge of $155.00, patients with high-deductible plans or those without insurance may find the cash price more affordable than their specific insurance allowed amount, which varies significantly across payers. For instance, while some commercial plans negotiate rates as low as $29, others like Humana and Aetna have negotiated ranges starting at $113 and extending up to $147. It is important to note that the facility's cash price of $101.00 is higher than the Medicare benchmark of $33.73, reflecting the standard markup for commercial services, but it remains the most predictable cost for patients who do not have insurance coverage.
Patients should proactively contact the hospital to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final bill by bypassing administrative claim processing fees. Although the facility is a Voluntary non-profit - Church owned Critical Access Hospital, there is no median paid data available for this specific service, so the negotiated rates listed represent the maximum amounts commercial insurers are contractually allowed to charge. When reviewing your own insurance coverage, be aware that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, but you should still verify your specific plan's allowed amount before scheduling to ensure you are not facing unexpected costs. Always request a full itemized bill before