Physical therapy (functional capacity test)
Facility: Bob Wilson Memorial Hospital
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $134
- Cash Discount Price: $66
- vs. Medicare Baseline: 3.97x 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 397% of the Medicare baseline (a markup of 297%). 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 |
|---|---|---|
| Humana | $53 | 157% |
| Medicare (plans) | $53 | 157% |
| Aetna | $53 - $131 | 157% |
| UnitedHealthcare | $53 - $137 | 157% |
| Kansas Health | $53 | 157% |
| Blue Cross Blue Shield | $71 | 210% |
| Centura Employee Plan | $72 | 213% |
| Multiplan | $148 - $153 | 439% |
| Health Partners Of Kansas | $154 | 457% |
| Wppa | $156 | 462% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test, Bob Wilson Memorial Hospital in Ulysses, KS, lists a cash median price of $66.00. This cash rate is significantly lower than the facility's gross charge of $164.00 and the median negotiated rate of $134.00. While the facility is a Critical Access Hospital owned by a voluntary non-profit church, patients should be aware that commercial insurance plans often pay negotiated rates that can exceed the cash price. For instance, Aetna and UnitedHealthcare have negotiated ranges extending up to $137, which is higher than the cash option. If you have a high-deductible plan or have not yet met your deductible, paying the cash price of $66.00 upfront could result in immediate savings compared to having your insurance process a claim at a higher negotiated rate.
To ensure you are not overcharged, it is advisable to request a prompt-pay discount before scheduling your visit, as hospitals often offer reductions of 20% to 50% for upfront payments. Additionally, if you receive a bill from an out-of-network provider or for services like emergency care at an in-network facility, the No Surprises Act may protect you from balance billing, meaning you should not pay the difference between the provider's full charge and your insurance allowed amount. Always ask for an itemized bill to verify that no services were unbundled or double-charged, as over 80% of hospital bills contain errors. Finally, compare the facility's rates to the broader market; while specific county or state averages are not provided in this dataset, understanding that commercial