CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Charlevoix Area Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $64
Cash Discount Price: $68
vs. Medicare Baseline: 1.90x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Charlevoix Area Hospital is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $68. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.90x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.

Cash / Self-Pay

$68

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $68 (202%)

Insurance Median: $64 (190%)

Cash: $68 (202% of Medicare)

Ins. Median: $64 (190% 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 Cross Blue Shield	$23 - $74	68%
Mclaren Health Plan	$23 - $74	68%
Meridian	$23	68%
Priority Health	$23 - $85	68%
UnitedHealthcare	$23 - $70	68%
Aetna	$32 - $72	95%
Blue Care Network	$32 - $38	95%
Hap (Health Alliance Plan)	$32 - $64	95%
Medicare (plans)	$32 - $38	95%
Michigan Amish Medical Board	$32 - $38	95%
Molina	$32 - $41	95%
Northern Michigan Mennonite Group	$32 - $38	95%
Provider Network Of America/Hma Group Health	$45 - $68	133%
Asr Physicians Care Network	$48 - $64	142%
Hospice Of Michigan	$48	142%
Nomi Health	$51 - $74	151%
Employee Benefits Logistics	$55 - $64	163%
Enterprise Group Planning Employee Benefit Plan	$64	190%
First Health/Coventry Health/Community Care Network	$64	190%
Medical Cost Savings Solution	$64	190%
Three Rivers Provider Network	$68	202%
Cofinity	$74	219%
Iba Health And Life Assurance Company	$74	219%
Preferred Medical Claim Solutions	$76	225%
Cigna	$80 - $85	237%

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 $68.
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 Charlevoix Area Hospital 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.