CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: North Adams Regional Hospital Corporation

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $61
  • Cash Discount Price: $90
  • vs. Medicare Baseline: 1.81x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at North Adams Regional Hospital Corporation is $61. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $90. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.81x the Medicare baseline. Located in 71 Hospital Avenue, North Adams, MA.
Cash / Self-Pay
$90

Average discount available for prompt cash payment at this facility.

Insurance Median
$61

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: $90 (267%)
Insurance Median: $61 (181%)
Cash: $90 (267% of Medicare)
Ins. Median: $61 (181% 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Blue Cross Blue Shield $21 - $80 62%
Medicare (plans) $21 - $37 62%
Comm Hospice $22 - $35 65%
Mcr Miscellaneous $22 - $35 65%
Mcrmanaged Cca One Care $22 - $39 65%
Mcrmanaged Usa Family $22 - $35 65%
Mcrmanaged Va $22 - $35 65%
Medicaid / KanCare $22 - $147 65%
Oth United Vaccn $22 - $35 65%
Mcd Masshealth $26 - $147 77%
Mcd New York $26 - $73 77%
Mcd Out Of State $26 - $147 77%
Mcdmanaged Cdphp $26 - $147 77%
Mcdmanaged Hne Mcdaco $26 - $147 77%
Comm Network Qhpsub $29 - $54 86%
Mcdmanaged Network $29 - $54 86%
Mcdmanaged Bmchnp $30 - $153 89%
Tricare $35 - $36 104%
Aetna $41 - $71 122%
Comm Fallon Qhp $52 - $54 154%
Wc Workers Comp $57 169%
Comm Network Qhpnonsub $61 - $68 181%
Comm Nhp $61 181%
Comm Unicare $61 - $69 181%
Comm Hne Hmo $64 - $65 190%
Comm Hne $67 - $69 199%
Comm Hne Ppo $67 - $69 199%
Comm Tufts $75 222%
UnitedHealthcare $81 240%
Cigna $85 - $88 252%
Comm Cdphp $85 252%
Comm Mvp $85 252%
Comm Oxford $85 252%
Comm First Health $88 - $90 261%
Comm Connecticare $90 267%
Comm Consolidated Health $90 267%
Comm Harvard $90 267%
Comm Other $90 267%
Comm Phcs $90 267%
Comm Self Pay $90 267%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 71 Hospital Avenue, North Adams, MA 01247
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Federal
  • Hospital Type: Critical Access Hospitals