Physical therapy (functional capacity test)
Facility: Amberwell Atchison Association
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $105
- Cash Discount Price: $206
- vs. Medicare Baseline: 3.11x 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 311% of the Medicare baseline (a markup of 211%). 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 - $54 | 151% |
| Humana | $68 - $93 | 202% |
| UnitedHealthcare | $68 - $370 | 202% |
| Triwest - All Plans | $68 | 202% |
| Va Ccn - All Plans | $68 | 202% |
| Superior Select Mcr Adv - All Plans | $68 | 202% |
| Ambetter / Centene | $105 | 311% |
| Aetna | $113 | 335% |
| Cigna | $113 | 335% |
| Centrus Health Direct - All Plans | $154 | 457% |
| Oscar - All Plans | $154 | 457% |
| Multiplan - All Plans | $161 | 477% |
| Wppa Providrs Care - All Plans | $185 | 548% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, Amberwell Atchison Association in Atchison, KS, lists a cash median price of $206.00. This cash rate is significantly higher than the state average, which is $33.73, and the facility's own negotiated rate of $105.00. While commercial payers like UnitedHealthcare and Humana have negotiated rates ranging from $68 to $370, the cash price remains the lowest option for patients without insurance. If you have a high-deductible plan where your deductible has not yet been met, paying the cash price of $206.00 upfront could save you money compared to the higher negotiated rates your insurer might apply.
To ensure you are receiving fair value, it is important to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, you should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full within 30 days, bypassing the administrative costs associated with insurance claims. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, they may offer specific self-pay or prompt-pay incentives that are not reflected in the standard negotiated rates. Always verify these discounts directly with the billing department before scheduling your appointment to avoid unexpected costs.