CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: University Medical Center of Princeton at Plainsboro

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $306
  • Cash Discount Price: $468
  • vs. Medicare Baseline: 9.07x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at University Medical Center of Princeton at Plainsboro is $306. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $468. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 9.07x the Medicare baseline. Located in One-Five Plainsboro Road, Plainsboro, NJ.
Cash / Self-Pay
$468

Average discount available for prompt cash payment at this facility.

Insurance Median
$306

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: $468 (1387%)
Insurance Median: $306 (907%)
Cash: $468 (1387% of Medicare)
Ins. Median: $306 (907% 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 907% of the Medicare baseline (a markup of 807%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Tricare $37 110%
Us Family Health Plan $37 110%
Aetna $38 - $390 113%
Blue Cross Blue Shield $38 - $352 113%
Medicare (plans) $38 - $41 113%
UnitedHealthcare $38 - $158 113%
Va Medical Center $38 113%
Cigna $39 - $468 116%
Clover Health Plan $40 119%
Humana $41 122%
Medicaid / KanCare $43 - $468 127%
Charity Care $44 130%
Wellcare $47 139%
Elap $53 - $68 157%
Horizon Nj Health $60 178%
Centivo $68 202%
Claim Watcher $68 202%
Preferred Health Care Eliance $122 362%
Horizon Behavioral Health $175 519%
Beacon Health Options $234 694%
Amerihealth $277 821%
Magnacare $299 - $328 886%
Princeton Theological Seminary $304 901%
First Managed Care Option $308 - $398 913%
Coventry $328 972%
Health Net $328 972%
Beech Street $374 - $398 1109%
Intergrated Health Plan $374 1109%
Intergroup $374 1109%
Penn Global Medicine Embassy Only $374 1109%
Allied Trades $398 1180%
Consumer Health Network $398 1180%
Devon Health Services $398 1180%
Ie Shaffer $398 1180%
Private Healthcare Systems $398 1180%
Qualcare $398 1180%
Total Care Network $398 1180%
Tri-State $398 1180%
Commercial Other $468 1387%
Compsych $468 1387%
Concern Plus $468 1387%
International Pfs $468 1387%
Life St. Francis $468 1387%
Magellan $468 1387%
Managed Health Network $468 1387%
Nj Carpenters $468 1387%
Penn Behavioral Health Corporate Services $468 1387%
Personnel Health Program $468 1387%
United Behavioral Health $468 1387%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One-Five Plainsboro Road, Plainsboro, NJ 08536
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals