CMS Price Transparency Data

Physical therapy (functional capacity test)

Facility: Union Hospital

Billing Code: 97750 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 97750
  • Insurance Median: $69
  • Cash Discount Price: $164
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Physical therapy (functional capacity test) at Union Hospital is $69. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $164. Compared to the federal Medicare reimbursement reference rate of $33.73, this hospital’s rate is 2.05x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$164

Average discount available for prompt cash payment at this facility.

Insurance Median
$69

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: $164 (486%)
Insurance Median: $69 (205%)
Cash: $164 (486% of Medicare)
Ins. Median: $69 (205% 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 205% of the Medicare baseline (a markup of 105%). 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
Buckeye $21 - $74 62%
Molina $21 - $78 62%
Summacare $21 - $118 62%
Caresource $22 - $74 65%
Amerihealth $23 - $82 68%
United $23 - $124 68%
Aetna $27 - $252 80%
Blue Cross Blue Shield $32 - $134 95%
Cigna $32 - $113 95%
Humana $32 - $43 95%
The Health Plan $32 - $217 95%
Valor $32 - $43 95%
Aultcare $33 - $113 98%
Communicare $33 - $45 98%
Mmo $33 - $164 98%
Perennial Health $34 - $46 101%
Pphp $34 - $35 101%
Zing Health $35 - $76 104%
Cc Ehp $36 - $188 107%
Devoted Health $43 127%
UnitedHealthcare $43 127%
Upmc $43 - $151 127%
Oscar $44 - $97 130%
Ohcp $63 - $122 187%
Omas $82 - $126 243%
Healthsmart $90 - $139 267%
Phphi $98 - $151 291%
Amish Community Aid Plan $113 - $126 335%
Gms $114 - $176 338%
Consociate Health $122 - $189 362%
Ohio Healthy $136 403%
Multiplan $147 - $227 436%
Php $151 448%
Medical Benefit Corp $176 522%
Frontpath $227 673%
Managed Care Services $227 673%
Tertiary Care Network $227 673%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals