CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Intermountain Health St Vincent Regional Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $68
Cash Discount Price: Unavailable
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Intermountain Health St Vincent Regional Hospital is $68. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.02x the Medicare baseline. Located in 1233 N 30Th St, Billings, MT.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$68

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%)

Insurance Median: $68 (202%)

Ins. Median: $68 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Medicare (plans)	$38	113%
UnitedHealthcare	$38 - $75	113%
First Choice Health	$44 - $73	130%
Other	$44 - $73	130%
Ebms-Employee Benefit Mng	$50 - $90	148%
Exchange Other	$50 - $54	148%
Meritain Health	$50 - $61	148%
Mt Health Co-Op	$50 - $54	148%
Aetna	$52	154%
Allegiance	$56 - $103	166%
Cigna	$56 - $74	166%
Blue Cross Blue Shield	$61 - $110	181%
Preferred One	$70 - $76	208%
Sibanye Stillwater Health Partners	$71	210%
Interwest	$74	219%
Pacificsource	$74 - $94	219%
Private Hlthcare Sys	$74	219%
Coastal Administrative Services	$75	222%
Geha	$75	222%
Pacific Steel And Recycling	$94	279%

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 $X.
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 Intermountain Health St Vincent Regional 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.