CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Alta Vista Regional Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $289
  • Cash Discount Price: $180
  • vs. Medicare Baseline: 8.57x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Alta Vista Regional Hospital is $289. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $180. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 8.57x the Medicare baseline. Located in 104 Legion Drive, Las Vegas, NM.
Cash / Self-Pay
$180

Average discount available for prompt cash payment at this facility.

Insurance Median
$289

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: $180 (534%)
Insurance Median: $289 (857%)
Cash: $180 (534% of Medicare)
Ins. Median: $289 (857% 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 857% of the Medicare baseline (a markup of 757%). 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
Commercial Hmo Ppo $28 - $361 83%
Medicaid / KanCare $30 - $361 89%
Php Centennial $30 89%
Medicare (plans) $35 - $361 104%
Champus $36 - $361 107%
UnitedHealthcare $51 - $58 151%
Mcare Mcaid Hmo Dual $58 172%
Workers Comp $148 - $361 439%
Self Pay $180 534%
Other Covernment $226 - $361 670%
Blue Cross Blue Shield $271 - $361 803%
Mva $361 1070%
Other Government $361 1070%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 104 Legion Drive, Las Vegas, NM 87701
  • CMS Rating: No CMS Rating
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals