CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Artesia General Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $156
Cash Discount Price: $110
vs. Medicare Baseline: 4.62x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Artesia General Hospital is $156. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $110. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 4.62x the Medicare baseline. Located in 702 N 13Th Street, Artesia, NM.

Cash / Self-Pay

$110

Average discount available for prompt cash payment at this facility.

Insurance Median

$156

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: $110 (326%)

Insurance Median: $156 (462%)

Cash: $110 (326% of Medicare)

Ins. Median: $156 (462% 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 462% of the Medicare baseline (a markup of 362%). 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
Blue Cross Blue Shield	$34 - $262	101%
Molina Healthcare Of New Mexico	$35	104%
Presbyterian Health Plan	$35 - $41	104%
UnitedHealthcare	$35 - $371	104%
Humana	$45 - $113	133%
Zelis	$45 - $218	133%
First Health	$64 - $392	190%
New Mexico Health Connections	$104 - $262	308%
Geha	$121 - $349	359%
Omni Networks	$121 - $305	359%
Three Rivers Provider Network	$130 - $327	385%
Cigna	$147 - $392	436%
Triwest	$152 - $384	451%
Galaxy Health	$156 - $392	462%
One Health Plan	$156 - $392	462%
Multiplan	$157 - $397	465%
United Payors & United Providers	$161 - $405	477%
Providence Risk & Insurance Services	$164 - $414	486%

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 $110.
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 Artesia General 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.