CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Trinity Health Livingston Hospital
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $140
- Cash Discount Price: $118
- vs. Medicare Baseline: 4.15x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Trinity Health Livingston Hospital is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 4.15x the Medicare baseline. Located in 620 Byron Rd, Howell, MI.
Cash / Self-Pay
$118
Average discount available for prompt cash payment at this facility.
Insurance Median
$140
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: $118 (350%)
Insurance Median: $140 (415%)
Cash: $118 (350% of Medicare)
Ins. Median: $140 (415% 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 415% of the Medicare baseline (a markup of 315%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Huron Valley Pace | $31 | 92% |
| Aetna | $32 - $122 | 95% |
| Align Senior Care | $32 | 95% |
| Blue Care Network Advantage | $32 | 95% |
| Blue Cross Blue Shield | $32 - $65 | 95% |
| Hospice Of Lansing | $32 | 95% |
| Medicare (plans) | $32 | 95% |
| Angela Hospice | $33 | 98% |
| UnitedHealthcare | $33 - $164 | 98% |
| Cca - Zing Health | $34 | 101% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $36 | 107% |
| Wc Accident Fund | $40 | 119% |
| Wc Advantage | $40 | 119% |
| Wc Aig | $40 | 119% |
| Wc Allied | $40 | 119% |
| Wc Amerisure | $40 | 119% |
| Wc Amtrust | $40 | 119% |
| Wc Asu Risk Mgt | $40 | 119% |
| Wc Berkley Admin | $40 | 119% |
| Wc Broadspire | $40 | 119% |
| Wc Bunch & Associates | $40 | 119% |
| Wc Ccmsi | $40 | 119% |
| Wc Emc Insurance Company | $40 | 119% |
| Wc Esis | $40 | 119% |
| Wc Fcci | $40 | 119% |
| Wc Federated | $40 | 119% |
| Wc Gallagher Bassett | $40 | 119% |
| Wc Genex Care For Ohio | $40 | 119% |
| Wc Guard Insurance Company | $40 | 119% |
| Wc Hartford | $40 | 119% |
| Wc Liberty Mutual | $40 | 119% |
| Wc Meijers | $40 | 119% |
| Wc Michigan | $40 | 119% |
| Wc Mitchell Frankenmuth | $40 | 119% |
| Wc Pma | $40 | 119% |
| Wc Sedgwick | $40 | 119% |
| Wc Sentry | $40 | 119% |
| Wc Travelers | $40 | 119% |
| Wc Tristar | $40 | 119% |
| Wc Walmart | $40 | 119% |
| Wc Zurich | $40 | 119% |
| Molina Marketplace | $42 | 125% |
| Health Cost Solutions | $50 | 148% |
| Vitalcore | $50 | 148% |
| Wellpath | $50 | 148% |
| U Of M Health Plan | $51 | 151% |
| Priority Health | $60 - $67 | 178% |
| Bcn Domestic | $65 | 193% |
| Blue Benefit Administrators Of Massachusetts | $65 | 193% |
| Blue Care Network | $65 | 193% |
| Blue Distinction Transplant | $65 | 193% |
| Blue Shield - Ca | $65 | 193% |
| Blue Shield - Id (Regence) | $65 | 193% |
| Blue Shield - Ny Highmark Northeastern | $65 | 193% |
| Blue Shield - Ny Highmark Western | $65 | 193% |
| Blue Shield - Pa (Highmark) | $65 | 193% |
| Blue Shield - Wa (Regence) | $65 | 193% |
| Health Choices | $65 - $148 | 193% |
| Kaiser Domestic | $65 | 193% |
| Employee Benefit Logistic | $73 | 216% |
| Acs Benefit Services | $86 | 255% |
| Allied Benefit Systems | $86 | 255% |
| Asr Health Benefits | $86 | 255% |
| Caresource | $86 | 255% |
| Claimchoice Adminstrators | $86 | 255% |
| Consociate | $86 | 255% |
| Cypress Benefit Administrators | $86 | 255% |
| Forest County Potawatomi | $86 | 255% |
| Hap | $86 - $141 | 255% |
| Health Smart | $86 | 255% |
| Healthgram | $86 | 255% |
| Healthscope | $86 | 255% |
| Secureone Preferred United Plans | $86 | 255% |
| Sisco Benefits | $86 | 255% |
| The Health Plan | $86 | 255% |
| Trustmark Small Business Benefits | $86 | 255% |
| Unified Group Services | $86 | 255% |
| Varipro | $86 | 255% |
| Webtpa | $86 | 255% |
| Geha | $122 - $133 | 362% |
| Meritain | $122 | 362% |
| Hospice Advantage | $127 | 377% |
| 1199 National Benefit Fund | $140 | 415% |
| Allied National Global Care | $140 | 415% |
| Asrm - Reliance Standard Life Insurance | $140 | 415% |
| Christian Care Ministry | $140 | 415% |
| Dean Health | $140 | 415% |
| Fallon Health | $140 | 415% |
| Family Life Insurance Company | $140 | 415% |
| Ghc Scw | $140 | 415% |
| Group Pension Administrators | $140 | 415% |
| International Benefit Administrators | $140 | 415% |
| Lifetime Benefit Solutions | $140 | 415% |
| Manhattan Life | $140 | 415% |
| Medi Share | $140 | 415% |
| Multiplan | $140 | 415% |
| Mvp | $140 | 415% |
| Pai | $140 | 415% |
| Pan-American Life | $140 | 415% |
| Paramount Hmo | $140 | 415% |
| Phcs | $140 | 415% |
| Trinity Health Share | $140 | 415% |
| Cigna | $141 | 418% |
| Health Partners | $141 | 418% |
| Tufts Health Plan | $141 | 418% |
| Prime Health Services | $146 | 433% |
| Access Health | $148 | 439% |
| Acclaim | $148 | 439% |
| Administrative Concepts | $148 | 439% |
| Allegeant | $148 | 439% |
| Ameriben | $148 | 439% |
| American Family | $148 | 439% |
| American Healthcare Alliance | $148 | 439% |
| American National | $148 | 439% |
| American Republic | $148 | 439% |
| Amerihealth | $148 | 439% |
| Aultcare | $148 | 439% |
| Automated Benefit Services | $148 | 439% |
| Auxiant | $148 | 439% |
| Benefit Administrative Systems,Llc | $148 | 439% |
| Boon Chapman | $148 | 439% |
| Cam Administrative Services | $148 | 439% |
| Christian Brother Services | $148 | 439% |
| Christian Brothers Holy Cross | $148 | 439% |
| Comprehensive Benefits | $148 | 439% |
| Continental Life Insurance | $148 | 439% |
| Coventry | $148 | 439% |
| Custom Benefit Administrators | $148 | 439% |
| Employee Benefit Concepts | $148 | 439% |
| Employee Benefit Management | $148 | 439% |
| Enterprise Group Planning | $148 | 439% |
| Freedom Life Insurance Company | $148 | 439% |
| Group Administrators | $148 | 439% |
| Group Marketing Services | $148 | 439% |
| Guardian | $148 | 439% |
| Health America | $148 | 439% |
| Healthcare Management Admin | $148 | 439% |
| Healthez | $148 | 439% |
| Humana | $148 | 439% |
| Insight | $148 | 439% |
| Intercare | $148 | 439% |
| Jfp Benefit Management | $148 | 439% |
| Jp Farley Corporation | $148 | 439% |
| Key Benefit Administrator | $148 | 439% |
| Liberty Union Life Assurance Co | $148 | 439% |
| Lucent Health | $148 | 439% |
| Luminare Health | $148 | 439% |
| Luminare Health (Detroit) | $148 | 439% |
| Magnacare | $148 | 439% |
| Medben | $148 | 439% |
| Medcost | $148 | 439% |
| Medical Mutual | $148 | 439% |
| Mutual Health Services | $148 | 439% |
| Mutual Of Omaha | $148 | 439% |
| Ncas | $148 | 439% |
| Nippon Life Ins | $148 | 439% |
| Nova | $148 | 439% |
| Painters Union Insurance Fund | $148 | 439% |
| Physicians Mutual | $148 | 439% |
| Plumbers Local 98 Insurance Fund | $148 | 439% |
| Prairie States | $148 | 439% |
| Preferred One | $148 | 439% |
| Primary Physician Care | $148 | 439% |
| Professional Benefit Administrators | $148 | 439% |
| Siho Insurance Services | $148 | 439% |
| The Loomis Company | $148 | 439% |
| Unicare | $148 | 439% |
| Us Health And Life | $148 | 439% |
| Valenz | $148 | 439% |
| Western & Southern Financial Group | $148 | 439% |
| Wps | $148 | 439% |
| First Health | $152 | 451% |
| Correctional Healthcare Consultants | $161 | 477% |
| Three Rivers Provider Network | $164 | 486% |
| Cmh Washtenaw County | $182 | 540% |