Physical therapy (functional capacity test)

For the CPT code 97750, representing a physical therapy functional capacity test, the gross charge at Satanta District Hospital is $75.00. While the facility's cash median rate is $68.00, which is lower than the gross charge, commercial insurance negotiated rates vary significantly across the 38 participating payers, ranging from $18.00 to $75.00. The median negotiated rate paid by insurers is $54.00, which is notably higher than the cash price. This discrepancy highlights that for patients with high-deductible plans, paying the cash price of $68.00 upfront may result in lower out-of-pocket costs compared to insurance claims where the allowed amount exceeds the cash rate. Additionally, patients should inquire directly with the hospital about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill by bypassing administrative processing fees inherent in the insurance billing cycle.

The facility's pricing structure is evaluated against federal benchmarks, with the Medicare amount for this service set at $33.73. The commercial negotiated rate of $54.00 represents a markup relative to this federal baseline, illustrating the difference between government-set cost standards and commercial contract rates. It is important to note that the data provided does not include specific county or state average comparisons for this procedure, so local market averages cannot be used to contextualize this specific facility's pricing. To ensure transparency, patients should request a detailed, itemized bill before payment to verify that all charges align with the negotiated rates and to identify any potential errors, as over 80% of hospital bills contain discrepancies. Finally, under the No Sur