CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Jacobson Memorial Hospital Care Center

Billing Code: 97750 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$134
about 3.9× the $34 Medicare rate · typically $42–$167
modeled estimate · not a bill or quote
Medicare pays $34 Fair price $134 Cash price $119 Hospital's list price $158

How we calculate the fair BaseRate →

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $120 - $158 356%
Blue Cross Blue Shieldmajor $158 - $221 468%
Aetnamajor $95 - $158 282%
Cignamajor $142 421%
Humanamajor $158 468%
HealthPartners $142 421%
Medica $126 374%
Sanford Health Plan $158 468%
+ 2 smaller / regional plans $126 - $158
Government programs also on file: Medicare, Medicaid, Military & VA.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: 601 East St N, Elgin, ND 58533
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals