CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Albany Medical Center Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $40
  • Cash Discount Price: $37
  • vs. Medicare Baseline: 1.19x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Albany Medical Center Hospital is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $37. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.19x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.
Cash / Self-Pay
$37

Average discount available for prompt cash payment at this facility.

Insurance Median
$40

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: $37 (110%)
Insurance Median: $40 (119%)
Cash: $37 (110% of Medicare)
Ins. Median: $40 (119% 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.

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
Aetna $10 - $260 30%
Nascentia Health Options $16 - $77 47%
Fidelis $18 - $214 53%
UnitedHealthcare $21 - $112 62%
Cdphp $22 - $214 65%
Empire Plan Nyship $24 - $112 71%
Magnacare $24 - $112 71%
Medicare (plans) $24 - $36 71%
Multiplan $25 - $119 74%
Blue Cross Blue Shield $27 - $214 80%
Tricare $27 - $32 80%
Blue Shield Highmark $28 - $70 83%
Emblem $29 - $269 86%
Hamaspik $30 - $223 89%
Mvp $31 - $95 92%
Blue Shield $35 - $283 104%
Emblem Health Ghi $36 - $70 107%
Nascentia $36 107%
Cigna $49 - $59 145%
Mvp Commercial $76 - $296 225%
Nys Department Of Corrections $77 228%
Emblem_Ghi $81 - $358 240%
Mvp Essential Plan $204 605%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 43 New Scotland Avenue, Mail Code 34, Albany, NY 12208
  • CMS Rating: ★☆☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals