CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Mercy Hospital - Cassville

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $112
Cash Discount Price: $91
vs. Medicare Baseline: 3.32x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mercy Hospital - Cassville is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $91. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.32x the Medicare baseline. Located in 94 Main Street, Cassville, MO.

Cash / Self-Pay

$91

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $91 (270%)

Insurance Median: $112 (332%)

Cash: $91 (270% of Medicare)

Ins. Median: $112 (332% 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 332% of the Medicare baseline (a markup of 232%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Medicaid / KanCare	$18 - $73	53%
Blue Cross Blue Shield	$32 - $136	95%
Medicare (plans)	$32 - $60	95%
UnitedHealthcare	$45 - $133	133%
Dept Of Veteran Affairs Contracted [320106]	$48	142%
Tricare	$57	169%
Aetna	$58 - $125	172%
Cherokee Nation Health Serv Contracted [320066]	$58	172%
Cigna	$58 - $133	172%
Cross Timbers Hospice [20098]	$58	172%
Elara Caring Aspire Hospice [20433]	$58	172%
Globalhealth Contracted [320145]	$58	172%
Halo Hcr Inc Hospice Contracted [320432]	$58	172%
Halo Hcr Inc Hospice [20432]	$58	172%
Humana	$58 - $119	172%
Indian Health Service Contracted [320198]	$58	172%
Kindful Hospice Contracted [320434]	$58	172%
Kindful Hospice [20434]	$58	172%
Medical Associates Health Contracted [320444]	$58	172%
Mercy Hospice Okc [20252]	$58	172%
Mercy Mgd Behavioral Health Contracted [320259]	$58	172%
Pace Of The Ozarks Contracted [320518]	$58	172%
Provider Partners Health Plans Contracted [320450]	$58	172%
Qual Choice Contracted [320325]	$58	172%
Healthscope Contracted [320182]	$59	175%
Administrative Payor Contracted [320005]	$63	187%
Centivo Contracted [320505]	$71	210%
Ambetter / Centene	$73	216%
Home State Health Plan Contracted [320187]	$73	216%
Novasys Contracted [320285]	$73	216%
Healthlink Contracted [320179]	$91 - $126	270%
Preferred Health Plan Contracted [320522]	$91	270%
Health Systems Inc Contracted [320174]	$112	332%
Insurance System Inc Contracted [320465]	$112	332%
Point C Contracted [320238]	$112 - $126	332%
Point C [20238]	$112	332%
United Medical Resources Contracted [320454]	$112 - $119	332%
Workers Comp [20426]	$112 - $126	332%
Municipal Health Plan Contracted [320271]	$113	335%
Medica Contracted [320239]	$125	371%
90 Degree Benefits Contracted [320436]	$126	374%
Aither Health Contracted [320449]	$126	374%
American Healthcare Alliance Contracted [320020]	$126	374%
Auxiant Contracted [320462]	$126	374%
Benefit Management Contracted [320052]	$126	374%
Ebms Contracted [320493]	$126	374%
Edison Health Solutions Contracted [320502]	$126	374%
Evolutions Health Care Contracted [320124]	$126	374%
Imagine 360 Contracted [320494]	$126	374%
Mercy Benefit Admin Contracted [320251]	$126	374%
Reflect Health Contracted [320492]	$126	374%
Show-Me Health Administrators Contracted [320483]	$126	374%
Usa Managed Care Org Contracted [320429]	$126	374%
Yuzu Health Contracted [320521]	$126	374%
First Health Contracted [320128]	$133	394%
Multiplan Contracted [320270]	$133	394%
Private Health Care Systems Contracted [320320]	$133	394%

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 $91.
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 Mercy Hospital - Cassville 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.