CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Caromont Regional Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $56
Cash Discount Price: $198
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Caromont Regional Medical Center is $56. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $198. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.66x the Medicare baseline. Located in 2525 Court Dr, Gastonia, NC.

Cash / Self-Pay

$198

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: $198 (587%)

Insurance Median: $56 (166%)

Cash: $198 (587% 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.

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
Alliance Behavioral Health	$30	89%
Amerihealth Caritas	$30	89%
Blue Cross Blue Shield	$30 - $53	89%
Carolina Complete Health	$30	89%
Carolina Complete Health Tailored Plans	$30	89%
Partners Behavioral Health	$30	89%
UnitedHealthcare	$30 - $148	89%
Vaya Behavioral Health	$30	89%
Wellcare	$30	89%
Aetna	$34 - $98	101%
Devoted Health	$34	101%
Healthteam	$34	101%
Longevity Health	$34	101%
Molina	$34 - $56	101%
Humana	$35 - $174	104%
Absolute Total Care	$56	166%
Surgery Plus	$57	169%
Cigna	$60 - $134	178%
Gaston County Jail	$60	178%
Carolina Caring	$81 - $157	240%
Corporate Benefits Service	$87	258%
Medcost	$135	400%
Beech Street	$162	480%
Multiplan	$162	480%
Self Pay	$178	528%
First Health Network	$188	557%

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 $198.
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 Caromont Regional 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.