Physical therapy (functional capacity test)
Facility: Stanton County Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $104
- Cash Discount Price: $110
- vs. Medicare Baseline: 3.08x 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 308% of the Medicare baseline (a markup of 208%). 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 | $51 - $110 | 151% |
| Healthy Blue Mcr Adv - All Other Plans | $103 - $113 | 305% |
| Healthy Blue Mcaid | $105 - $116 | 311% |
Consumer Guidance & Cost Commentary
For this physical therapy functional capacity test at Stanton County Hospital in Johnson, KS, the cash price of $110.00 is significantly lower than the negotiated rates charged to insurance payers, which range from $103.00 to $116.00 depending on the specific plan. While the facility is a Critical Access Hospital with government-local ownership, patients with high-deductible plans may find paying the full cash price upfront more cost-effective than relying on insurance, as the insurer's allowed amount often exceeds the cash rate. The cash price also aligns perfectly with the facility's own median cash rate, offering a clear baseline for self-pay patients who wish to avoid administrative fees associated with claims processing.
When evaluating the facility's pricing against broader benchmarks, the Medicare amount of $33.73 serves as the most reliable indicator of the true cost of care, revealing that the cash price represents a substantial markup over federal reimbursement standards. Although the facility's median negotiated rate of $104.00 is lower than the gross charge, it remains higher than the Medicare baseline, illustrating the typical administrative and contractual costs embedded in commercial insurance contracts. To maximize savings, patients should request a prompt-pay discount before scheduling, which can reduce the bill by 20% to 50% if paid in full within 30 days, and should avoid signing any waivers that might void this cash agreement or trigger balance billing for out-of-network ancillary services.