CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $32
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.95x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Ascension Providence Hospital, Southfield and Novi is $32. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 0.95x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$32

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%)

Insurance Median: $32 (95%)

Ins. Median: $32 (95% 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.

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
Blue Caid Michigan	$18	53%
Harbor Health Mcd	$18	53%
Medicaid / KanCare	$18 - $32	53%
Molina Health	$18	53%
Total Health Care	$18	53%
UnitedHealthcare	$18	53%
Amerihealth Vip Care Mcr	$27 - $31	80%
Aetna	$32	95%
Auto Insurance	$32	95%
Humana	$32	95%
Jvhl - Mcr Replacement	$32	95%
Mcr Replacement	$32	95%
Veterans Choice	$32	95%
Meridian Wellcare	$33	98%
Molina Advantage	$33	98%
Hap Alliance Health	$36	107%
Hap Hmo Pos	$36	107%
Ambetter / Centene	$40	119%
Molina Marketplace	$40	119%
Hap Preferred	$43	127%
Smart Health	$44	130%
Bc Metro Detroit Epo	$45	133%
Bc Metro Detroit Hmo	$45	133%
Bcn Local Network Southeast	$45 - $46	133%
Blue Care Network	$45	133%
Blue Cross Blue Shield	$45	133%

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 $X.
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 Ascension Providence Hospital, Southfield and Novi 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.