Physical therapy (functional capacity test)
Facility: Great Plains Of Sabetha
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $67
- Cash Discount Price: $73
- vs. Medicare Baseline: 1.99x 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.
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 |
|---|---|---|
| Aetna | $34 - $129 | 101% |
| Celtic Mcr Adv | $34 - $67 | 101% |
| Celtic Comm Exchange-All Other Plans | $42 - $83 | 125% |
| Great West Healthcare-All Plans | $55 - $109 | 163% |
| UnitedHealthcare | $60 - $128 | 178% |
| Humana | $62 - $122 | 184% |
| Century/Wppa/Providers-All Plans | $62 - $122 | 184% |
| Federated Mutual Ins-All Plans | $62 - $123 | 184% |
| Multiplan-Phcs-All Plans | $62 - $122 | 184% |
| Cigna | $62 - $122 | 184% |
| Medicaid / KanCare | $65 - $128 | 193% |
| Blue Cross Blue Shield | $65 - $128 | 193% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, Great Plains of Sabetha in Sabetha, KS, lists a cash median of $73.00. This cash rate is notably higher than the Medicare benchmark of $33.73, which serves as the federal baseline for the true cost of this service. While the facility offers a negotiated rate of $67.00 to in-network payers, this amount remains above the Medicare amount, illustrating that commercial insurance contracts often result in higher out-of-pocket costs for patients who have not yet met their deductibles. Patients with high-deductible plans may find that paying the cash price of $73.00 upfront is more cost-effective than relying on insurance, as the negotiated rates from major carriers like UnitedHealthcare and Humana range from $62.00 to $128.00, frequently exceeding the cash option.
To minimize financial exposure, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing administrative claim processing fees. It is critical to avoid accepting summary bills without reviewing the full itemized statement, as over 80% of hospital invoices contain errors such as unbundled codes or charges for services not rendered. Furthermore, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, patients must ensure they do not sign away these rights via consent waivers during registration. Given that Great Plains of Sabetha is a Critical Access Hospital with a voluntary non-profit ownership structure, verifying the