Physical therapy (functional capacity test)
Facility: Cheyenne County Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $98
- Cash Discount Price: $109
- vs. Medicare Baseline: 2.91x 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 291% of the Medicare baseline (a markup of 191%). 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 | $53 | 157% |
| First Health - All Plans | $58 - $95 | 172% |
| Healthy Blue Mcr Adv | $59 - $98 | 175% |
| Aetna | $59 - $129 | 175% |
| UnitedHealthcare | $59 - $230 | 175% |
| Tricare | $59 - $98 | 175% |
| Choice Care - All Plans | $60 - $99 | 178% |
| Firstguard - All Plans | $66 - $109 | 196% |
| Wppa - All Plans | $74 - $122 | 219% |
| Preferred Hc - All Plans | $78 - $129 | 231% |
| Cpm - All Plans | $78 - $129 | 231% |
| Midlands Choice - All Plans | $80 - $132 | 237% |
| Unicare - All Plans | $81 - $133 | 240% |
| Ppo Next - All Plans | $81 - $133 | 240% |
| Integrated Hp - All Plans | $81 - $133 | 240% |
| Health Partners - All Plans | $81 - $133 | 240% |
| Healthy Blue Mcaid - All Other Plans | $82 - $136 | 243% |
| Childrens Mercy - All Plans | $82 - $136 | 243% |
| Healthwave Mcaid - All Plans | $82 - $136 | 243% |
| Providers Care-All Plans | $123 - $204 | 365% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, Cheyenne County Hospital in St. Francis, KS, lists a cash price of $109.00. This cash rate is identical to the facility's negotiated median of $98.00 and matches the gross charge, suggesting no significant discount exists for self-pay patients. The Medicare benchmark for this service is $33.73, indicating that the facility's cash price is approximately 2.9 times the federal government's standard rate. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, the pricing data shows that the cash price remains high relative to the Medicare baseline, which is often used to evaluate fair market value.
Insurance payers negotiate rates that generally fall between $53 and $230, with the lowest negotiated amount being $53 from Blue Cross Blue Shield. Although the facility's cash price of $109.00 is higher than the median negotiated rate of $88.00, patients with high-deductible plans may find paying out-of-pocket cheaper if their insurance allows the full negotiated rate, which could exceed the cash price. It is important to verify your specific plan's allowed amount before scheduling, as in-network rates vary significantly across different carriers. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can reduce the final bill by bypassing administrative claim processing costs.