CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Perham Health

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $39
Cash Discount Price: $70
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Perham Health is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $70. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.16x the Medicare baseline. Located in 1000 Coney Street West, Perham, MN.

Cash / Self-Pay

$70

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $70 (208%)

Insurance Median: $39 (116%)

Cash: $70 (208% of Medicare)

Ins. Median: $39 (116% 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	$30 - $73	89%
Health Partners Mcr Adv	$37	110%
Humana	$37	110%
Medica Mcr Adv	$37	110%
Medicare (plans)	$37 - $41	110%
Ucare Mn Senior Health Options	$37	110%
UnitedHealthcare	$38 - $84	113%
Medicaid / KanCare	$39	116%
Ucare Mn Medical Assistance	$39	116%
Ucare Mn Minnesota Care	$39	116%
Ucare Mn Senior Care Plus	$39	116%
Ucare Mn Special Needs Basic Care	$39	116%
Ucare Mn Special Needs Basic Care Dual	$39	116%
Medica Mcaid Mn Care	$40	119%
Medica Mn (Msho)	$44	130%
Ucare Individual And Family Plan-All Other Plans	$45	133%
Medica Mn Senior Hp/Outside Mn	$49	145%
Health Partners Minnesota Care	$54	160%
Medica Commercial-All Other Plans	$79	234%
Preferred One (Pchp, Pic, Pas)-All Other Plans	$81	240%
Health Partners-All Plans	$89	264%
Preferred One (Ppo)	$92	273%
Sanford Health Plan-All Plans	$92	273%

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 $70.
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 Perham Health 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.