CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Chelsea Hospital
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $121
- Cash Discount Price: $118
- vs. Medicare Baseline: 3.59x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Chelsea Hospital is $121. 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 3.59x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$118
Average discount available for prompt cash payment at this facility.
Insurance Median
$121
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: $121 (359%)
Cash: $118 (350% of Medicare)
Ins. Median: $121 (359% 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 359% of the Medicare baseline (a markup of 259%). 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.
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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 | $33 - $100 | 98% |
| Align Senior Care | $33 | 98% |
| Angela Hospice | $33 | 98% |
| Arbor Hospice | $33 | 98% |
| Blue Care Network Advantage | $33 | 98% |
| Blue Cross Blue Shield | $33 - $68 | 98% |
| Heartland Hospice | $33 | 98% |
| Medicare (plans) | $33 | 98% |
| UnitedHealthcare | $34 - $122 | 101% |
| Cca - Zing Health | $35 | 104% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $38 | 113% |
| Molina Marketplace | $44 | 130% |
| Wc Accident Fund | $48 | 142% |
| Wc Advantage | $48 | 142% |
| Wc Aig | $48 | 142% |
| Wc Allied | $48 | 142% |
| Wc Amerisure | $48 | 142% |
| Wc Amtrust | $48 | 142% |
| Wc Asu Risk Mgt | $48 | 142% |
| Wc Berkley Admin | $48 | 142% |
| Wc Broadspire | $48 | 142% |
| Wc Bunch & Associates | $48 | 142% |
| Wc Ccmsi | $48 | 142% |
| Wc Emc Insurance Company | $48 | 142% |
| Wc Esis | $48 | 142% |
| Wc Fcci | $48 | 142% |
| Wc Federated | $48 | 142% |
| Wc Gallagher Bassett | $48 | 142% |
| Wc Genex Care For Ohio | $48 | 142% |
| Wc Guard Insurance Company | $48 | 142% |
| Wc Hartford | $48 | 142% |
| Wc Liberty Mutual | $48 | 142% |
| Wc Meijers | $48 | 142% |
| Wc Michigan | $48 | 142% |
| Wc Mitchell Frankenmuth | $48 | 142% |
| Wc Pma | $48 | 142% |
| Wc Sedgwick | $48 | 142% |
| Wc Sentry | $48 | 142% |
| Wc Travelers | $48 | 142% |
| Wc Tristar | $48 | 142% |
| Wc Walmart | $48 | 142% |
| Wc Zurich | $48 | 142% |
| U Of M Health Plan | $51 | 151% |
| Health Cost Solutions | $52 | 154% |
| Vitalcore | $52 | 154% |
| Wellpath | $52 | 154% |
| Priority Health | $60 - $67 | 178% |
| Bcn Domestic | $68 | 202% |
| Blue Benefit Administrators Of Massachusetts | $68 | 202% |
| Blue Care Network | $68 | 202% |
| Blue Distinction Transplant | $68 | 202% |
| Blue Shield - Ca | $68 | 202% |
| Blue Shield - Id (Regence) | $68 | 202% |
| Blue Shield - Ny Highmark Northeastern | $68 | 202% |
| Blue Shield - Ny Highmark Western | $68 | 202% |
| Blue Shield - Pa (Highmark) | $68 | 202% |
| Blue Shield - Wa (Regence) | $68 | 202% |
| Health Choices | $68 - $121 | 202% |
| Kaiser Domestic | $68 | 202% |
| Employee Benefit Logistic | $75 | 222% |
| Asr Health Benefits | $86 | 255% |
| Caresource | $86 | 255% |
| Hap | $86 - $141 | 255% |
| Varipro | $86 | 255% |
| Geha | $100 - $122 | 296% |
| Meritain | $100 | 296% |
| Access Health | $121 | 359% |
| Acclaim | $121 | 359% |
| Administrative Concepts | $121 | 359% |
| Allegeant | $121 | 359% |
| Ameriben | $121 | 359% |
| American Family | $121 | 359% |
| American Healthcare Alliance | $121 | 359% |
| American National | $121 | 359% |
| American Republic | $121 | 359% |
| Amerihealth | $121 | 359% |
| Aultcare | $121 | 359% |
| Automated Benefit Services | $121 | 359% |
| Auxiant | $121 | 359% |
| Benefit Administrative Systems,Llc | $121 | 359% |
| Boon Chapman | $121 | 359% |
| Cam Administrative Services | $121 | 359% |
| Christian Brother Services | $121 | 359% |
| Christian Brothers Holy Cross | $121 | 359% |
| Comprehensive Benefits | $121 | 359% |
| Continental Life Insurance | $121 | 359% |
| Custom Benefit Administrators | $121 | 359% |
| Employee Benefit Concepts | $121 | 359% |
| Employee Benefit Management | $121 | 359% |
| Enterprise Group Planning | $121 | 359% |
| Freedom Life Insurance Company | $121 | 359% |
| Group Administrators | $121 | 359% |
| Group Marketing Services | $121 | 359% |
| Guardian | $121 | 359% |
| Health America | $121 | 359% |
| Healthcare Management Admin | $121 | 359% |
| Healthez | $121 | 359% |
| Humana | $121 | 359% |
| Insight | $121 | 359% |
| Intercare | $121 | 359% |
| Jfp Benefit Management | $121 | 359% |
| Jp Farley Corporation | $121 | 359% |
| Key Benefit Administrator | $121 | 359% |
| Liberty Union Life Assurance Co | $121 | 359% |
| Lucent Health | $121 | 359% |
| Luminare Health | $121 | 359% |
| Luminare Health (Detroit) | $121 | 359% |
| Magnacare | $121 | 359% |
| Medben | $121 | 359% |
| Medcost | $121 | 359% |
| Medical Mutual | $121 | 359% |
| Mutual Health Services | $121 | 359% |
| Mutual Of Omaha | $121 | 359% |
| Ncas | $121 | 359% |
| Nippon Life Ins | $121 | 359% |
| Nova | $121 | 359% |
| Painters Union Insurance Fund | $121 | 359% |
| Physicians Mutual | $121 | 359% |
| Plumbers Local 98 Insurance Fund | $121 | 359% |
| Prairie States | $121 | 359% |
| Preferred One | $121 | 359% |
| Primary Physician Care | $121 | 359% |
| Professional Benefit Administrators | $121 | 359% |
| Siho Insurance Services | $121 | 359% |
| Sisco Benefits | $121 | 359% |
| The Loomis Company | $121 | 359% |
| Unicare | $121 | 359% |
| Us Health And Life | $121 | 359% |
| Valenz | $121 | 359% |
| Western & Southern Financial Group | $121 | 359% |
| Wps | $121 | 359% |
| Coventry | $124 | 368% |
| First Health | $124 | 368% |
| Hospice Of Michigan | $127 | 377% |
| Cigna | $128 | 379% |
| 1199 National Benefit Fund | $136 | 403% |
| Allied National Global Care | $136 | 403% |
| Asrm - Reliance Standard Life Insurance | $136 | 403% |
| Christian Care Ministry | $136 | 403% |
| Dean Health | $136 | 403% |
| Fallon Health | $136 | 403% |
| Family Life Insurance Company | $136 | 403% |
| Ghc Scw | $136 | 403% |
| Group Pension Administrators | $136 | 403% |
| International Benefit Administrators | $136 | 403% |
| Lifetime Benefit Solutions | $136 | 403% |
| Manhattan Life | $136 | 403% |
| Medi Share | $136 | 403% |
| Multiplan | $136 | 403% |
| Mvp | $136 | 403% |
| Pai | $136 | 403% |
| Pan-American Life | $136 | 403% |
| Paramount Hmo | $136 | 403% |
| Phcs | $136 | 403% |
| Trinity Health Share | $136 | 403% |
| Health Partners | $141 | 418% |
| Tufts Health Plan | $141 | 418% |
| Prime Health Services | $146 | 433% |
| Three Rivers Provider Network | $164 | 486% |
| Cmh Detroit Wayne Integrated Health Network | $182 | 540% |
| Cmh Jackson County/Lifeways | $182 | 540% |
| Cmh Lenawee County | $182 | 540% |
| Cmh Livingston County | $182 | 540% |
| Cmh Misc | $182 | 540% |
| Cmh Monroe County | $182 | 540% |
| Cmh Washtenaw County | $182 | 540% |
| Magellan Behavioral Health | $182 | 540% |