CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Novant Health Forsyth Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $83
Cash Discount Price: $73
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Novant Health Forsyth Medical Center is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.46x the Medicare baseline. Located in 3333 Silas Creek Parkway, Winston-Salem, NC.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $73 (216%)

Insurance Median: $83 (246%)

Cash: $73 (216% of Medicare)

Ins. Median: $83 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Carolina Complete	$22 - $23	65%
Nc Department Of Public Safety	$22 - $23	65%
Amerihealth	$23	68%
Blue Cross Blue Shield	$23 - $89	68%
UnitedHealthcare	$23 - $83	68%
Wellcare	$23	68%
Cigna	$46 - $73	136%
Caresource North Carolina	$48 - $49	142%
Aetna	$60 - $98	178%
Atlantic Corporation Dba Atlantic Packaging	$67 - $69	199%
Plotkin Health	$71 - $74	210%
Amps	$77 - $80	228%
Humana	$93 - $96	276%
Medcost	$101 - $116	299%
Primary Physician Care	$105 - $108	311%
Beechstreet	$107 - $111	317%
Multiplan	$107 - $111	317%
Phcs	$107 - $111	317%
Employers Choice Network	$115 - $119	341%
Three Rivers Provider Network	$115 - $119	341%

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 $73.
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 Novant Health Forsyth Medical Center 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.