CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Atrium Health Union

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $36
  • Cash Discount Price: $42
  • vs. Medicare Baseline: 1.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Atrium Health Union is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $42. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 600 Hospital Dr, Monroe, NC.
Cash / Self-Pay
$42

Average discount available for prompt cash payment at this facility.

Insurance Median
$36

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: $42 (125%)
Insurance Median: $36 (107%)
Cash: $42 (125% of Medicare)
Ins. Median: $36 (107% 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
Alliance $11 - $24 33%
Amerihealth Caritas $11 - $23 33%
Carolina Complete Health $11 - $23 33%
Healthy Blue $11 - $23 33%
Partners $11 - $23 33%
UnitedHealthcare $11 - $40 33%
Vaya $11 - $23 33%
Wellcare $11 - $23 33%
Trillium $12 - $23 36%
Blue Cross Blue Shield $21 - $31 62%
Aetna $22 - $52 65%
Ambetter / Centene $25 - $31 74%
Cigna $32 - $57 95%
Humana $32 95%
Employers Health Network $37 110%
Ortho Carolina $40 119%
Medcost $46 - $55 136%
Magellan $51 151%
Gmmi $55 163%
Quik Trip $55 163%
Healthgram $68 202%
Choicecare $72 213%
First Health $72 213%
Beechstreet $76 225%
Private Health Care Systems $76 225%
Provider Select $76 225%
Multiplan $80 237%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 Hospital Dr, Monroe, NC 28112
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals