Physical therapy (functional capacity test)
Facility: Goodland Regional Medical Center
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $82
- Cash Discount Price: $82
- vs. Medicare Baseline: 2.43x 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 243% of the Medicare baseline (a markup of 143%). 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 | $54 | 160% |
| Wppa | $77 - $82 | 228% |
| UnitedHealthcare | $82 | 243% |
Consumer Guidance & Cost Commentary
For this Physical therapy (functional capacity test) at Goodland Regional Medical Center in Goodland, KS, the cash median price is $82.00, which is lower than the negotiated rates of $77 to $82 paid by Wppa and UnitedHealthcare, as well as the $54 rate from Blue Cross Blue Shield. While the facility is a Critical Access Hospital with a government-local ownership structure, patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. It is important to note that while the facility offers a cash median of $82.00, which aligns with the median negotiated rate, patients should verify if their specific insurance plan has a lower allowed amount that could result in a lower out-of-pocket cost depending on their deductible status.
To avoid unexpected balance billing, patients should request a prompt-pay discount of 20% to 50% before scheduling, as paying upfront bypasses costly administrative processing and collection fees. If a patient receives a bill that includes charges for services not rendered or unbundled components, they should immediately request a formal itemized billing audit to identify errors, as over 80% of hospital bills contain mistakes that can be corrected through written dispute. Furthermore, since the Medicare amount for this service is $33.73, commercial rates should be compared against this federal benchmark rather than the facility's gross charges to understand the true markup, ensuring that any negotiated or cash rates are fair and transparent.