CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Arnot Ogden Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $87
Cash Discount Price: $127
vs. Medicare Baseline: 2.58x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Arnot Ogden Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.58x the Medicare baseline. Located in 600 Roe Avenue, Elmira, NY.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $127 (377%)

Insurance Median: $87 (258%)

Cash: $127 (377% of Medicare)

Ins. Median: $87 (258% 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 258% of the Medicare baseline (a markup of 158%). 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
Empire	$21	62%
Aetna	$27 - $119	80%
Blue Cross Blue Shield	$27 - $481	80%
Amerihealth Mcr Adv - All Plans	$33	98%
Humana	$33 - $143	98%
Tricare	$33	98%
Geisinger	$44 - $78	130%
Fidelis	$48 - $78	142%
Fidelis Care-Exchange - All Plans	$70 - $87	208%
Geisinger - All Plans	$74 - $92	219%
Icircle	$78	231%
UnitedHealthcare	$78 - $109	231%
Cigna	$79 - $99	234%
Mvp Health Plan - All Plans	$79 - $99	234%
Independent Health - All Plans	$82 - $103	243%
Upmc Health Plan - All Plans	$88 - $109	261%
Pomco Inc - All Plans	$91 - $114	270%
Emblem Health - All Plans	$112 - $139	332%
Emblem/Ghi	$117	347%
Martins Point Mcr Adv - All Plans	$127 - $159	377%
Healthnow - All Plans	$382 - $478	1133%

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 $127.
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 Arnot Ogden Medical Center 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.