CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: University of Louisville Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $70
Cash Discount Price: $42
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at University of Louisville Hospital is $70. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.08x the Medicare baseline. Located in 530 South Jackson Street, Louisville, KY.

Cash / Self-Pay

$42

Average discount available for prompt cash payment at this facility.

Insurance Median

$70

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$33.73

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $33.73 (100%)

Cash / Self-Pay: $42 (125%)

Insurance Median: $70 (208%)

Cash: $42 (125% of Medicare)

Ins. Median: $70 (208% of 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 208% of the Medicare baseline (a markup of 108%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Aetna	$30	89%
Blue Cross Blue Shield	$30 - $176	89%
Humana	$30 - $31	89%
UnitedHealthcare	$30 - $84	89%
Essence Health	$31	92%
Passport	$31 - $88	92%
Va Ccn	$31	92%
Senior Care Community Of Ky	$32	95%
Signature	$32 - $88	95%
Communicare	$33	98%
Devoted	$33 - $53	98%
Wellcare	$36 - $44	107%
Key Benefit Administrators	$40	119%
Velocity	$40 - $172	119%
Prime Group Health	$49 - $150	145%
Cigna	$102	302%
Cshn	$114 - $176	338%
Multiplan	$116 - $158	344%
Encore	$123	365%
Health Smart	$132	391%
Omca	$167	495%
Corvel	$176	522%
National Comp Care	$176	522%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $42.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 97750.

Insurance In-Network Protection Plan

Contact your insurance company to confirm University of Louisville Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 97750.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.