CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Jacobi Medical Center

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $134
Cash Discount Price: Unavailable
vs. Medicare Baseline: 3.97x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Jacobi Medical Center is $134. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 3.97x the Medicare baseline. Located in 1400 Pelham Parkway South, Bronx, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$134

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%)

Insurance Median: $134 (397%)

Ins. Median: $134 (397% 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 397% of the Medicare baseline (a markup of 297%). 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
Aetna	$20 - $192	59%
Healthfirst	$31 - $282	92%
Wellcare	$41	122%
Fidelis	$55 - $282	163%
Blue Cross Blue Shield	$73 - $282	216%
Centerlight	$114	338%
Metroplus	$118 - $282	350%
Amidacare	$125	371%
Carelon	$125 - $148	371%
Senior Whole Health	$125	371%
United	$125 - $330	371%
United Behavioral Health	$125 - $138	371%
Affinity	$128 - $282	379%
Carelon (Amida Care)	$128	379%
Vnsny	$128 - $193	379%
Elderplan	$148	439%
Emblem	$157 - $228	465%
Magnacare	$170	504%
Multiplan	$182	540%
Local 1199	$193	572%
Villagecare Max	$209	620%
Oxford	$236 - $265	700%
Cigna	$241	714%
Oscar	$251	744%

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 $X.
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 Jacobi 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.