Physical therapy (functional capacity test)
Facility: Morris County Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $68
- Cash Discount Price: $68
- vs. Medicare Baseline: 2.02x 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 202% of the Medicare baseline (a markup of 102%). 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 |
|---|---|---|
| Choice Care Mcr Adv-All Plans | $44 | 130% |
| Va Ccn-All Plans | $44 | 130% |
| Blue Cross Blue Shield | $44 - $54 | 130% |
| UnitedHealthcare | $44 - $114 | 130% |
| Coventry Mcr | $44 | 130% |
| Cigna | $82 | 243% |
| Aetna | $102 | 302% |
| Coventry Comm-All Other Plans | $103 | 305% |
| Multiplan-All Plans | $103 | 305% |
| Providrs Care (Wppa)(Nexus)-All Plans | $171 | 507% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, Morris County Hospital in Council Grove, KS, lists a cash median price of $68.00 and a median negotiated rate of $68.00. This cash price is notably lower than the gross charge of $114.00, which serves as the starting point for insurance negotiations. While the facility is a Critical Access Hospital with government-local ownership, patients should be aware that commercial insurance carriers like UnitedHealthcare and Blue Cross Blue Shield have negotiated rates ranging from $44 to $114, with some plans paying up to $171. In cases where a patient's insurance deductible has not been met, paying the cash price of $68.00 upfront could result in immediate savings compared to the higher negotiated rates their plan might otherwise require.
To ensure you are not overcharged, it is critical to request a full itemized bill before finalizing payment, as summary bills often obscure individual line items and potential errors. If you choose to use insurance, remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, but you must verify your specific plan's allowed amount to avoid unexpected costs. Additionally, since hospitals often offer prompt-pay discounts of 20% to 50% for upfront cash payments, you should explicitly ask the billing department about self-pay or prompt-pay rates prior to scheduling your visit to maximize potential savings and avoid administrative fees associated with insurance claims.