CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Missouri Baptist Sullivan Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $56
  • Cash Discount Price: $49
  • vs. Medicare Baseline: 1.66x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Missouri Baptist Sullivan Hospital is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $49. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.66x the Medicare baseline. Located in 751 Sappington Bridge Rd, Sullivan, MO.
Cash / Self-Pay
$49

Average discount available for prompt cash payment at this facility.

Insurance Median
$56

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: $49 (145%)
Insurance Median: $56 (166%)
Cash: $49 (145% of Medicare)
Ins. Median: $56 (166% 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 - $62 53%
Essence Healthcare [221] $18 53%
Humana $18 - $55 53%
UnitedHealthcare $18 - $61 53%
Blue Cross Blue Shield $19 - $216 56%
Cox Health [757] $19 56%
Medica [662] $19 56%
Devoted Health Plan [847] $20 59%
Healthlink [225] $40 - $62 119%
Cox Health Systems Insurance Company [220] $45 - $53 133%
Health Alliance [224] $45 133%
Allied Benefits [498] $48 - $61 142%
Hope Trust [806] $48 142%
Coresource [497] $49 145%
Fmh Benefit Service Inc [222] $49 145%
Mail Handlers [495] $49 145%
Cigna $50 - $66 148%
Healthscope Benefits [258] $53 - $55 157%
Med-Pay [480] $53 - $62 157%
Unicare [568] $53 - $62 157%
Apwu Health Plan [216] $56 166%
Nalc Health Benefit Plan [242] $56 166%
Priority Health [648] $56 166%
First Health Commercial [734] $61 181%
Beechstreet [551] $62 184%
Detego Health [868] $62 184%
Health Systems Inc [620] $62 184%
Healthcare Sol Mercy [609] $62 184%
Multiplan Commercial [737] $62 184%
Multiplan [240] $62 184%
Phcs [244] $62 - $66 184%
Preferred Health Professionals [561] $62 184%
Hfn [563] $66 196%
Medica [661] $66 196%
Consociate [478] $237 703%
Sarah Bush Lincoln [636] $237 703%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 751 Sappington Bridge Rd, Sullivan, MO 63080
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals