CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Essentia Health Sandstone

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $55
  • Cash Discount Price: $86
  • vs. Medicare Baseline: 1.63x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Essentia Health Sandstone is $55. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $86. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.63x the Medicare baseline. Located in 705 Lundorff Drive South, Sandstone, MN.
Cash / Self-Pay
$86

Average discount available for prompt cash payment at this facility.

Insurance Median
$55

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: $86 (255%)
Insurance Median: $55 (163%)
Cash: $86 (255% of Medicare)
Ins. Median: $55 (163% 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
Itasca Med Care $33 98%
Primewest $34 101%
Blue Cross Blue Shield $45 - $94 133%
Blue Plus Pmap Pcc Prime $45 133%
Healthpartners Care Pmap $47 139%
Medica Access $47 139%
Sanford Healthplan $50 - $53 148%
Advocare/Security Health $55 163%
Freedom Blue Ppo $55 163%
Healthpartners Care Msho / Mcr Adv $55 163%
Imcare Msho Pcc Prime $55 163%
Imcare Msho Ref Req $55 163%
Medica Advantage Solutions $55 163%
Medica Msho/Dual Solutions $55 163%
Medica Prime Solution Group $55 163%
Medicare (plans) $55 163%
Nd Va Administration $55 163%
Platinum Blue/Vantage Blue $55 163%
Primewest Msho $55 163%
Secure Blue Msho $55 163%
Ubh Cost Plan $55 163%
Ubh Msho $55 163%
Ucare Msho $55 163%
UnitedHealthcare $55 - $106 163%
Ucare $77 228%
Healthpartners $79 - $91 234%
Medica $84 - $93 249%
Medica Uplan $84 249%
Wea $84 - $90 249%
America'S Ppo $91 270%
Cigna $91 270%
Healthpartners Pcc Prime $91 270%
Medica Choice $96 285%
Wps $98 291%
Aetna $99 294%
Security Health $117 347%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 705 Lundorff Drive South, Sandstone, MN 55072
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals