CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Lafayette Regional Health Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $52
  • Cash Discount Price: $120
  • vs. Medicare Baseline: 1.54x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Lafayette Regional Health Center is $52. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $120. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.54x the Medicare baseline. Located in 1500 State Street, Lexington, MO.
Cash / Self-Pay
$120

Average discount available for prompt cash payment at this facility.

Insurance Median
$52

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: $120 (356%)
Insurance Median: $52 (154%)
Cash: $120 (356% of Medicare)
Ins. Median: $52 (154% 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
Aetna $18 - $105 53%
Amerigroup $18 53%
Healthyblue $18 53%
Home State Health Plan $18 53%
Medicaid / KanCare $18 53%
Unicare $18 53%
United $18 - $54 53%
Ambetter / Centene $22 65%
Nhc Advantage $23 68%
Universal Healthcare $31 92%
Humana $41 - $52 122%
Blue Cross Blue Shield $46 - $120 136%
Corvel Corporation $50 - $102 148%
Oha Network $50 - $60 148%
College Park Family Care Center $52 154%
Oscar $60 178%
Cigna $69 - $86 205%
Wppa Providrs Care Network $90 267%
Multiplan $94 279%
Coventry $96 285%
Coventry Kc Mo $96 285%
Cco, Inc. $102 302%
Focus Healthcare Mgmt, Inc $108 320%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 State Street, Lexington, MO 64067
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals