CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Ochsner Medical Center Acute

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $103
Cash Discount Price: $111
vs. Medicare Baseline: 3.05x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Ochsner Medical Center Acute is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.05x the Medicare baseline. Located in 1516 Jefferson Hwy, New Orleans, LA.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $111 (329%)

Insurance Median: $103 (305%)

Cash: $111 (329% of Medicare)

Ins. Median: $103 (305% 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 305% of the Medicare baseline (a markup of 205%). 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
Medicaid / KanCare	$28 - $29	83%
Tricare	$29 - $33	86%
Aetna	$57 - $483	169%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$57 - $446	169%
Blue Cross Blue Shield	$57 - $446	169%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$57 - $446	169%
Ochsner Health Plan	$57 - $446	169%
Christus Health Exchange Plan	$76	225%
First Health Network	$86 - $669	255%
Louisiana Workers' Compensation Corporation (Lwcc)	$86 - $669	255%
Mississippi Physicians Care Network	$86 - $669	255%
Healthcomp & Personify Health (Formerly Gilsbar)	$90 - $705	267%
Claritev D/B/A Multiplan/Phcs/American Life Care	$91 - $714	270%
Zelis	$91 - $714	270%
Employers Health Network (Ehn)	$97 - $758	288%
Prime Health Services Ppo	$97 - $758	288%
Usa Managed Care Network	$97 - $758	288%
Behavioral Health Systems	$103 - $803	305%
Evolutions Healthcare	$103 - $803	305%
Galaxy Health Network Ppo	$103 - $803	305%
Galaxy Health Network Wc	$103 - $803	305%
UnitedHealthcare	$114 - $892	338%
Cigna	$441	1307%

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 $111.
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 Ochsner Medical Center Acute 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.