CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Frisbie Memorial Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $105
Cash Discount Price: $1,472
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Frisbie Memorial Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,472. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.11x the Medicare baseline. Located in 11 Whitehall Road, Rochester, NH.

Cash / Self-Pay

$1,472

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $1,472 (4364%)

Insurance Median: $105 (311%)

Cash: $1,472 (4364% of Medicare)

Ins. Median: $105 (311% 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 311% of the Medicare baseline (a markup of 211%). 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
Amerihealth Caritas	$22 - $221	65%
Aetna	$30 - $1,550	89%
Blue Cross Blue Shield	$30 - $1,073	89%
Humana	$30 - $34	89%
United VA Ccn	$30 - $34	89%
United	$31 - $1,617	92%
Evernorth Behavioral Health	$31 - $35	92%
Cigna	$31 - $35	92%
Well Sense Health Plan	$32 - $327	95%
Martin's Point Health	$32 - $36	95%
Ambetter / Centene	$54 - $61	160%
Harvard Pilgrim	$69 - $1,086	205%
Maine Community Health	$74 - $1,296	219%
Tufts Health Plan	$90 - $1,534	267%
Evernorth	$209 - $2,146	620%

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 $1,472.
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 Frisbie Memorial 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.