Physical therapy (functional capacity test)
Facility: Logan County Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $95
- Cash Discount Price: $21
- vs. Medicare Baseline: 2.82x 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 282% of the Medicare baseline (a markup of 182%). 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 |
|---|---|---|
| Humana | $42 - $47 | 125% |
| Blue Cross Blue Shield | $54 | 160% |
| Health Partners - All Plans | $95 - $104 | 282% |
| Medicaid / KanCare | $100 - $110 | 296% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) service at Logan County Hospital in Oakley, KS, the facility's cash median rate of $21.00 is significantly lower than the state average, which sits at $71.00. While the hospital's negotiated rates with major payers like Humana, Blue Cross Blue Shield, and Health Partners range from $42 to $110, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, this specific service may not be covered under that federal protection if the provider is considered out-of-network for this particular code.
To ensure you receive the most accurate pricing, always request a full itemized bill before paying, as summary invoices can obscure individual charges or unbundled codes that inflate the total. If you choose to pay directly, ask the billing department about "prompt-pay" discounts, which can reduce the final amount by 20% to 50% when paid upfront. Additionally, since the facility is a Critical Access Hospital with government ownership, verify if any self-pay or prompt-pay discounts are available before scheduling, as these rates are often lower than the standard negotiated amounts listed for insurance plans.