CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Saratoga Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 97750
Insurance Median: $36
Cash Discount Price: $51
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Saratoga Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $51. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 1.07x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$51

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $51 (151%)

Insurance Median: $36 (107%)

Cash: $51 (151% of Medicare)

Ins. Median: $36 (107% 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.

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	$18 - $37	53%
Blue Cross Blue Shield	$21 - $181	62%
UnitedHealthcare	$21 - $98	62%
Cdphp	$22 - $220	65%
Fidelis	$24 - $220	71%
Medicare (plans)	$24 - $32	71%
Tricare	$27 - $32	80%
Blue Shield Highmark	$29 - $33	86%
Hamaspik	$30 - $229	89%
Mvp	$31 - $59	92%
Emblem Health Ghi	$32 - $36	95%
Nascentia Health Options	$46	136%
Emblem	$47 - $72	139%
Cigna	$49 - $59	145%
Empire Plan Nyship	$58 - $72	172%
Mvp Commercial	$68 - $215	202%
Multiplan	$73 - $88	216%
Magnacare	$87 - $98	258%
Mvp Essential Plan	$98 - $195	291%
Mvp Govt Programs	$98	291%
Blue Shield	$138 - $256	409%

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 $51.
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 Saratoga 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.