Physical therapy (functional capacity test)
Facility: Cloud County Health Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $138
- Cash Discount Price: $105
- vs. Medicare Baseline: 4.09x 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 409% of the Medicare baseline (a markup of 309%). 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 |
|---|---|---|
| Aetna | $87 - $190 | 258% |
| Pponext-All Plans | $91 - $194 | 270% |
| Mpi-All Plans | $91 - $194 | 270% |
| Health Partners - All Plans | $91 - $194 | 270% |
Consumer Guidance & Cost Commentary
For the Physical therapy (functional capacity test) procedure at Cloud County Health Center in Concordia, KS, the cash price is $105, which is lower than the facility's negotiated rate of $138. While the facility is a Critical Access Hospital, the specific comparison data provided does not include state or county averages for this service code; therefore, no direct comparison to regional pricing benchmarks is available in this report. Patients should note that while cash payments may appear cheaper, commercial insurance plans often negotiate rates that can exceed the cash price, making it financially beneficial to verify your specific plan's negotiated amount before scheduling. Additionally, because this is a non-profit facility, you should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts, which can further reduce the final amount owed if you settle the bill upfront.
The Medicare benchmark for this service is $33.73, which serves as the objective baseline for evaluating pricing markups. The facility's cash rate of $105 represents a significant markup over the Medicare amount, reflecting the costs of physician work, practice expenses, and administrative overhead. When reviewing your bill, ensure you receive an itemized statement rather than a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered that can be disputed. If you receive a balance bill for the difference between the provider's rate and your insurance allowed amount, remember that the No Surprises Act protects you from these unexpected charges for non-emergency services at in-network facilities, allowing you to dispute the bill with your insurer rather than paying immediately.