CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Ste Genevieve County Memorial Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $137
Cash Discount Price: $173
vs. Medicare Baseline: 4.06x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Ste Genevieve County Memorial Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $173. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 4.06x the Medicare baseline. Located in Hwys 61 & 32, Sainte Genevieve, MO.

Cash / Self-Pay

$173

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $173 (513%)

Insurance Median: $137 (406%)

Cash: $173 (513% of Medicare)

Ins. Median: $137 (406% 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 406% of the Medicare baseline (a markup of 306%). 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
Blue Cross Blue Shield	$34 - $164	101%
Medicare (plans)	$34 - $140	101%
Va	$34 - $140	101%
Aetna	$35 - $432	104%
Allwell	$35 - $143	104%
Pphp	$39 - $161	116%
Ambetter / Centene	$43 - $175	127%
Healthy_Blue	$56 - $229	166%
Medicaid / KanCare	$56 - $229	166%
Uhc_Community	$56 - $229	166%
Homestate	$57 - $233	169%
UnitedHealthcare	$68 - $280	202%
Meritain	$105 - $432	311%
Cigna	$112 - $460	332%
Multiplan/Phcs	$116 - $477	344%
Healthlink_Compmanagement	$122 - $499	362%
Healthlink_Hmo	$122 - $499	362%
Healthlink_Ppo	$122 - $499	362%

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 $173.
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 Ste Genevieve County Memorial 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.