Physical therapy (functional capacity test)
Facility: Ascension Via Christi Rehabilitation Hospital Inc
Billing Code: 97750 (CPT)
- CPT Billing Code: 97750
- Insurance Median: $32
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.95x 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.
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 |
|---|---|---|
| Medicare (plans) | $31 - $32 | 92% |
| Vc Hope | $31 | 92% |
| Humana | $31 | 92% |
| Va | $31 | 92% |
| UnitedHealthcare | $32 - $88 | 95% |
| Blue Cross Blue Shield | $32 | 95% |
| Smarthealth | $44 | 130% |
| Medicaid / KanCare | $53 | 157% |
| Aetna | $72 | 213% |
Consumer Guidance & Cost Commentary
For the CPT code 97750, representing a physical therapy functional capacity test at Ascension Via Christi Rehabilitation Hospital Inc in Wichita, KS, the facility's negotiated rates range from $31 to $88 depending on the insurance plan. While the median negotiated rate across all payers is $32.00, the Medicare benchmark for this service is $33.73. This indicates that the facility's average negotiated rate is slightly below the federal Medicare baseline, which often serves as a reliable indicator of the true cost of care. However, individual commercial rates vary significantly; for instance, UnitedHealthcare plans show a wide range from $32 to $88, while most other payers, including Medicare plans and Vc Hope, have a consistent rate of $31 to $32. Patients should be aware that while in-network insurance provides protection against balance billing, the actual amount paid can fluctuate based on specific plan contracts and deductibles.
When considering payment options, patients with high-deductible plans or those without insurance may find that paying cash directly could result in lower out-of-pocket costs compared to the insurance negotiated rates, as commercial contracts often include administrative overhead that inflates the final price. It is important to note that cash-pay rates are not explicitly listed in the current data, so patients should directly contact the hospital to inquire about self-pay or prompt-pay discounts, which can typically reduce the total bill by 20% to 50% if paid in full upfront. Additionally, consumers should request an itemized bill before finalizing payment to ensure there are no errors, unbundled codes, or charges for services not rendered, as summary bills can obscure these discrepancies.