CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Capital Health Medical Center - Hopewell

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $169
Cash Discount Price: $1,293
vs. Medicare Baseline: 5.01x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Capital Health Medical Center - Hopewell is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,293. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 5.01x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$1,293

Average discount available for prompt cash payment at this facility.

Insurance Median

$169

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: $1,293 (3833%)

Insurance Median: $169 (501%)

Cash: $1,293 (3833% of Medicare)

Ins. Median: $169 (501% 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 501% of the Medicare baseline (a markup of 401%). 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
UnitedHealthcare	$14 - $461	42%
Medicaid / KanCare	$15 - $492	44%
Wellpoint	$15 - $498	44%
Aetna	$19 - $3,467	56%
Blue Cross Blue Shield	$36 - $1,378	107%
Clover	$36	107%
Humana	$37	110%
Medicare (plans)	$37	110%
Fidelis	$57	169%
Horizon Nj Health	$60	178%
Oxford Benefit Plan	$109 - $161	323%
Cigna	$177 - $8,638	525%
Multiplan	$304 - $9,790	901%

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 $1,293.
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 Capital Health Medical Center - Hopewell 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.