CMS Price Transparency Data
Physical therapy (functional capacity test)
Facility: Mercy St Francis Hospital
Billing Code: 97750 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 97750
- Insurance Median: $115
- Cash Discount Price: $91
- vs. Medicare Baseline: 3.41x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Mercy St Francis Hospital is $115. 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 3.41x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.
Cash / Self-Pay
$91
Average discount available for prompt cash payment at this facility.
Insurance Median
$115
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: $115 (341%)
Cash: $91 (270% of Medicare)
Ins. Median: $115 (341% 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 341% of the Medicare baseline (a markup of 241%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 - $77 | 53% |
| Blue Cross Blue Shield | $32 - $144 | 95% |
| Medicare (plans) | $32 - $53 | 95% |
| Tricare | $41 - $50 | 122% |
| Aetna | $42 - $132 | 125% |
| Cherokee Nation Health Serv Contracted [320066] | $42 - $51 | 125% |
| Cigna | $42 - $141 | 125% |
| Cross Timbers Hospice [20098] | $42 - $51 | 125% |
| Dept Of Veteran Affairs Contracted [320106] | $42 - $51 | 125% |
| Elara Caring Aspire Hospice [20433] | $42 - $51 | 125% |
| Globalhealth Contracted [320145] | $42 - $51 | 125% |
| Halo Hcr Inc Hospice Contracted [320432] | $42 - $51 | 125% |
| Halo Hcr Inc Hospice [20432] | $42 - $51 | 125% |
| Humana | $42 - $133 | 125% |
| Indian Health Service Contracted [320198] | $42 - $51 | 125% |
| Kindful Hospice Contracted [320434] | $42 - $51 | 125% |
| Kindful Hospice [20434] | $42 - $51 | 125% |
| Medical Associates Health Contracted [320444] | $42 - $51 | 125% |
| Mercy Hospice Okc [20252] | $42 - $51 | 125% |
| Mercy Mgd Behavioral Health Contracted [320259] | $42 - $51 | 125% |
| Pace Of The Ozarks Contracted [320518] | $42 - $51 | 125% |
| Provider Partners Health Plans Contracted [320450] | $42 - $51 | 125% |
| Qual Choice Contracted [320325] | $42 - $51 | 125% |
| UnitedHealthcare | $42 - $141 | 125% |
| Administrative Payor Contracted [320005] | $54 - $67 | 160% |
| Healthscope Contracted [320182] | $55 - $67 | 163% |
| Ambetter / Centene | $63 - $77 | 187% |
| Home State Health Plan Contracted [320187] | $63 - $77 | 187% |
| Novasys Contracted [320285] | $63 - $77 | 187% |
| Centivo Contracted [320505] | $70 - $86 | 208% |
| Healthlink Contracted [320179] | $79 - $141 | 234% |
| Preferred Health Plan Contracted [320522] | $79 - $96 | 234% |
| Workers Comp [20426] | $97 - $126 | 288% |
| Auxiant Contracted [320462] | $109 - $141 | 323% |
| Mercy Benefit Admin Contracted [320251] | $109 - $141 | 323% |
| Point C Contracted [320238] | $109 - $141 | 323% |
| United Medical Resources Contracted [320454] | $109 - $138 | 323% |
| Medica Contracted [320239] | $114 - $140 | 338% |
| 90 Degree Benefits Contracted [320436] | $115 - $141 | 341% |
| Aither Health Contracted [320449] | $115 - $141 | 341% |
| Benefit Management Contracted [320052] | $115 - $141 | 341% |
| Ebms Contracted [320493] | $115 - $141 | 341% |
| Edison Health Solutions Contracted [320502] | $115 - $141 | 341% |
| Evolutions Health Care Contracted [320124] | $115 - $141 | 341% |
| First Health Contracted [320128] | $115 - $141 | 341% |
| Health Systems Inc Contracted [320174] | $115 - $141 | 341% |
| Imagine 360 Contracted [320494] | $115 - $141 | 341% |
| Insurance System Inc Contracted [320465] | $115 - $141 | 341% |
| Multiplan Contracted [320270] | $115 - $141 | 341% |
| Point C [20238] | $115 - $141 | 341% |
| Private Health Care Systems Contracted [320320] | $115 - $141 | 341% |
| Reflect Health Contracted [320492] | $115 - $141 | 341% |
| Show-Me Health Administrators Contracted [320483] | $115 - $141 | 341% |
| Usa Managed Care Org Contracted [320429] | $115 - $141 | 341% |
| Yuzu Health Contracted [320521] | $115 - $141 | 341% |